ArticleJHEP reports : innovation in hepatology2025
Comparative risk of osteoporosis and fractures in chronic hepatitis B patients: Tenofovir disoproxil fumarate vs. entecavir in a Korean nationwide cohort.
Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- A Nomogram for Predicting Tenofovir-Associated Osteoporosis in Chronic Hepatitis B.Journal of clinical medicine · 2026Article
- Recommendations for treatment of viral hepatitis B in 2026 by the Polish Group of Experts for HBV.Clinical and experimental hepatology · 2026Review
- Bone health and chronic viral infections: A narrative literature review.World journal of virology · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: The optimal antiviral agent for patients with chronic hepatitis B (CHB) at risk for osteoporosis remains debated. The aim of this study was to compare the incidence of osteoporosis and osteoporotic fractures between patients treated with tenofovir disoproxil fumarate (TDF) and entecavir (ETV) using a nationwide cohort in South Korea. Method: We analyzed 40,404 patients with CHB treated with either TDF (n = 23,779) or ETV (n = 16,625). The risk of osteoporosis and osteoporotic fractures was evaluated using Cox proportional hazards models, incidence rate ratios (IRRs), and Kaplan-Meier survival analysis. To adjust for baseline differences, inverse probability of treatment weighting was applied. Result: Over a mean follow-up of 50.8 months, osteoporosis occurred in 1,712 TDF users and 1,094 ET V users. The incidence rate of osteoporosis was significantly higher in the TDF group (IRR 1.30, 95% CI 1.23-1.37; Conclusion: Long-term use of TDF is associated with a significantly increased risk of osteoporosis and fractures, especially in patients aged ≥60 years. These findings support the need for proactive bone health surveillance in patients with CHB receiving long-term TDF therapy. Impact and implications: Our study highlights the need for careful antiviral selection in patients with chronic hepatitis B aged ≥60 due to the increased risk of osteoporosis and fractures with long-term tenofovir disoproxil fumarate use. We recommend using entecavir or tenofovir alafenamide fumarate as the preferred therapies for patients at high risk of fractures. Early intervention is essential, as fracture incidence tends to rise after 2-3 years of tenofovir disoproxil fumarate therapy, making regular bone mineral density monitoring critical for these patients.
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