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TDF to TAF Switch HBV Safety — SCE Infectious Diseases MCQ

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HardHepatitisTDF to TAF Switch HBV SafetySCE Infectious Diseases

A patient with chronic hepatitis B has undetectable HBV DNA on tenofovir disoproxil but develops progressive proximal tubular dysfunction. There is no cirrhosis or prior tenofovir resistance. Which switch preserves HBV activity while reducing renal exposure?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Switch to tenofovir alafenamide 25 mg once daily

Tenofovir alafenamide is active against HBV and can maintain viral suppression after TDF while lowering systemic tenofovir exposure, improving renal and bone safety in suitable patients. HBV therapy must not simply be stopped because rebound and hepatitis flares can occur.

Reference: Vemlidy 25 mg SmPC. https://www.medicines.org.uk/emc/product/2314/smpc