Background Some studies have suggested a lipid-lowering effect of tenofovir (TDF) in HIV infected patients who take antiretroviral therapy. Whether this effect appears in other kinds of patients remains unknown.

Purpose To assess the lipid-lowering effects of TDF in patients with chronic hepatitis B.

Materials and methods Retrospective single-institution study. Inclusion criteria: adults with chronic hepatitis B, not HIV-co-infected, treated with tenofovir since 2009. The authors included patients treated with TDF for at least one month and a baseline value for total cholesterol levels (TC) and triglycerides.

Demographics (age, sex) and treatment data (prior antiviral treatment, lipid-lowering treatment) were collected. TC and baseline triglycerides values were compared with those obtained 3-6 months after the start of treatment. Mean values were compared using Student's two-tailed test for paired samples.

Results Eighteen patients were included. Ten patients (56%) were male. Mean (±SD) age was 47.7±10.8 years. None of the patients took lipid-lowering agents at baseline or during the study. Seven patients (38.9%) received other hepatitis B treatment before tenofovir. Only one patient took another antihepatitis drug combined with TDF. At baseline, the mean±SD lipids (mg/dl) were 202.4±38.9 for TC and 96.2±45.2 for triglycerides. After 3-6 months of tenofovir treatment mean values were 174.6±30.9 for total cholesterol and 97.2±49,2 mg/dl for triglycerides. The TC levels of 16 patients (89%) improved with a mean reduction of 27.6 mg/dl (CI 95% 12.8-42,3) which is a statistically significant difference (p=0.001). Triglycerides did not improve significantly (difference-1.0 mg/dl CI 95% -20.9 to 18.9; p=0.917). These results are consistent with those found in HIV-infected patients.

Conclusions TC decreased significantly over the study period for most patients. TDF did not seem to have a positive effect on triglycerides. These data give the first evidence of a lipid-lowering effect of TDF in chronic hepatitis B patients although it must be confirmed in a prospective study.