The Effect of Entecavir and Tenofovir Disoproxil on Bone Mineral Density in Chronic Hepatitis B Treatment

Background/Aim:Evaluation of the relationship between drugs and osteoporosis in patients receiving entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment for chronic hepatitis B infection (CHB). Material and Method: The study included patients who received ETV or TDF treatment for at least 12 months between 2016 and 2021 and underwent bone mineral densitometry (BMD) measurement within 12 months after treatment. Demographic characteristics of the patients and the association of antiviral drug use with osteopenia/osteoporosis were retrospectively. Results: The study included 170 patients, 92 (54.1%) of whom were male, with a mean age at diagnosis of 36.57 ± 14.88 years. Of the patients, 24 (14.1%) were on ETV and 146 (85.9%) were on TDF. The mean age at BMD measurement was 48.62 ± 13.4 years. The median time from diagnosis to BMD was 138.5 (15-373) months. Osteopenia/osteoporosis was found in 14 (15.2%) of male patients and 25 (32.1%) of female patients. The frequency of osteopenia/osteoporosis was significantly higher in women (p=0.011). There was no significant difference in the frequency of osteopenia/osteoporosis between ETV and TDF (p=0.112). Lumbar spine (LS) BMD was significantly higher in TDF users (p=0.043). While no patient had a BMD within 12 months of treatment initiation, 6 (3.5%) of the patients had a BMD within 24 months, 8 (4.7%) within 36 months and 25 (14.7%) within 60 months of treatment initiation. Conclusion: There was no significant difference in the development of osteopenia/osteoporosis in patients using TDF and ETV. It was found that bone mineral measurements of patients with CHB were not performed regularly and appropriately.