Hepatitis B Crónica

What is TAF for Chronic HBV?

Tenofovir alafenamide is a newer prodrug of tenofovir with better renal and bone safety profiles than TDF. It suppresses HBV replication to undetectable levels in 95%+ of patients, preventing progression to cirrhosis and HCC.

Why China?

• HBV capital: China has 86M chronic HBV carriers — top hepatology centers see more cases than any country
• Cost: $35-$80/month (domestic/biosimilar) vs. $1,500-$2,200/month US branded
• Comprehensive care: Integrated HCC surveillance + fibrosis monitoring
• Pregnancy expertise: Mother-to-child transmission prevention protocols (gold standard)

Who is a candidate?

• HBV DNA ≥20,000 IU/mL (HBeAg+) or ≥2,000 IU/mL (HBeAg−) with elevated ALT
• Cirrhosis (treat regardless of HBV DNA/ALT level)
• Immunosuppression or chemotherapy (prophylactic treatment)
• Pregnant women at high-risk for vertical transmission (3rd trimester)

Outcomes

HBV DNA undetectable: 95%+ at 1 year. ALT normalization: 85-90%. HBeAg seroconversion: 10-15% annually. HBsAg loss (functional cure): 1-3% annually. HCC risk reduction: 50-70%.