Considering a Switch from Tenofovir Alafenamide to Entecavir - seeking advice

Hello HepB Community,

I am a 32-year-old male, diagnosed with chronic hepatitis B since birth and have been on antiviral treatment for the past 15 years. I want to share my current medical status and seek your insights regarding a proposed change in my medication.

Here are my present health details:

  • HbsAg positive

  • HbeAg positive

  • HBV DNA undetected

  • Hbs Quantitative stable around 3,000 units (previously it was around 50,000)

  • Normal blood count and liver functions

  • No steatosis

  • No mutations to Lamivudine or Entecavir

  • Genotype D (I’m from Europe)

I initially started my therapy with Tenofovir and for the past 4 years, I have been on Tenofovir Alafenamide. Recently, my doctor raised concerns regarding my cholesterol levels, which could potentially put me at risk of heart disease and fatty liver in the future. My LDL cholesterol has been hovering around 240 mg/dL over the past 4 years, considerably above the normal upper limit of 130.

Considering my normal weight status and other health parameters, my doctor suspects Tenofovir Alafenamide might be causing the elevated cholesterol. He recommended Omega-3 supplements and proposed a potential switch to Entecavir.

Given this context, I would greatly appreciate your thoughts:

  • Do you think the switch from Tenofovir Alafenamide to Entecavir is warranted in my case?

  • How is the switch typically executed? Would I need to take both medications in parallel for a certain period?

  • What do you see as the pros and cons of this proposed decision?

Any advice or shared experiences would be highly valuable. Thank you in advance for your insights.

Hi @learnandshare,

Thanks for sharing your story and welcome back to the forum. As I’m not a medical doctor, I can’t really comment on the decision to switch or not, but we have had several threads on the forum that might be able to answer some of your questions (No causation with vemlidy and cholesterol level for older women?; Switch from TAF to Entecavir?; and Switching meds and side effects)


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Hi Thomas,

Appreciate the valuable resources. I’ll look into these threads to get a better understanding. Thanks for your guidance.


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