Abstract: Objective To investigate the efficacy and safety of Tenofovir alafenamide? (TAF) in the the newly treated patients with decompensated hepatitis B cirrhosis. Methods A total of 72 patients were retrospectively analysed in the study, 34 of whom received TAF treatment and 38 of whom received TDF treatment in Wuwei tumor Hospital of Gansu from October 2021 to October 2023.After 24 weeks and 48 weeks of treatment,we compared the changes in ALT,TBil,Alb, PT, CTP scores, and the proportion of patients with virological response (HBVDNA <20 IU/mL) between the two groups. In terms of safety,we compared changes in Scr and BUN, as well as drug-related adverse events. Results After 48 weeks of treatment, the median ALT was 27.10 U/L in the TAF group, which was significantly lower than the median ALT of 30.90 U/L in the TDF group (P < 0.05). Additionally, the Alb level in the TAF group was 39.73 g/L and 41.69 g/L after 24 and 48 weeks of treatment respectively, and this improvement was superior to the TDF group (P<0.05). The virological response rate of HBV DNA was 97.1% and 81.6% in the TAF and TDF groups after 48 weeks of treatment respectively, indicating a better viral response rate for TAF (P<0.05). The Child-Pugh scores significantly decreased in both groups after 24 and 48 weeks of treatment, but the difference was not statistically significant (P>0.05). Regarding safety, after 48 weeks of TAF treatment. BUN and Scr levels were significantly lower in the TAF group compared to the TDF group (P<0.05). No drug-related adverse events or serious adverse events were reported during the treatment period. Conclusion TAF is effective and safe for patients with decompensated hepatitis B liver cirrhosis.

Key words: Tenofovir alafenamide, Hepatitis B, decompensated cirrhosis, Clinical studies