To investigate the difference in efficacy between tenofovir (TDF) and entecavir (ETV) in the initial treatment of chronic hepatitis B (CHB).

A total of 100 CHB patients treated in Zhumadian Central Hospital from November 2019 to November 2021 were selected, and they were divided into control group and observation group by the two-color ball method, with 50 cases in each group. The control group was treated with ETV initially, and the observation group was treated with TDF initially. The therapeutic effects, alanine aminotransferase (ALT), hepatitis B virus (HBV-DNA), inflammatory factor levels, negative conversion rate of HBV-DNA, ALT normalization rate and adverse reactions of the two groups were compared.

Before treatment, there was no significant difference in levels of ALT and inflammatory factors between the two groups (P>0.05). After 12 weeks of treatment, the levels of ALT, HBV-DNA, and inflammatory factors in the observation group were lower than those in the control group (all P<0.05). After 12 weeks of treatment, the negative conversion rate of HBV-DNA and renormalization rate of ALT in the observation group (54.00%, 27/50; 56.00%, 28/50) were higher than those in the control group (30.00%, 15/50; 32.00%, 16/50), P<0.05. However, there was no significant difference in negative conversion rate of HBV-DNA and normalization rate of ALT between the two groups after 36 weeks of treatment (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Both TDF and ETV can achieve good therapeutic effects in the initial treatment of CHB patients. TDF initial treatment can promote the reduction of ALT, HBV-DNA and inflammatory factors faster, accelerate process of HBV-DNA converting to negative, increase normalization rate of ALT, without significant increase in adverse reactions.

Hepatitis B, chronic; Tenofovir; Entecavir; Initial therapy; hepatitis B virus; Alanine aminotransferase normalization; Quality of life