Effects of tenofovir alafenamide combined with pegylated interferon on clinical symptoms and renal function indicators in patients with chronic hepatitis B.

Abstract

Chronic hepatitis B (CHB) can progress to cirrhosis and liver can-cer. Although antiviral therapy is standard, monotherapy has limitations. This ret-rospective study evaluated the efficacy of tenofovir alafenamide fumarate (TMF) combined with pegylated interferon (Peg-IFNα2b) in 220 CHB patients treated from June 2021 to June 2024. Patients were divided into monotherapy (TMF) and combination therapy (TMF + Peg-IFNα2b) groups. Clinical indicators were assessed at baseline and at 12, 24, and 48 weeks. The combination group had sig-nificantly lower HBV-DNA levels at all follow-up points (p<0.05) and higher rates of HBV-DNA negativity at 48 weeks (71.82% vs. 57.27%, p=0.024). HBsAg levels were lower and HBeAg seroconversion rates higher in the combination group (p<0.05). Clinical symptom improvement and ALT normalization were better in the combination group at 24 and 48 weeks (p<0.05), with greater reductions in liver stiffness (p<0.05). No significant differences were observed in renal func-tion (eGFR) or TBIL between groups. Adverse reactions were more frequent in the combination group but were mild and manageable. Multivariate analysis iden-tified age (OR=0.042), obesity (OR=0.012), and baseline eGFR (OR=0.816) as independent factors for renal dysfunction. TMF combined with Peg-IFNα2b improves virological response, clinical symptoms, and liver function while main-taining acceptable safety, supporting its use as a promising CHB treatment.