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Entecavir + tenofovir amibufenamide is a combination antiviral regimen being investigated for the treatment of chronic hepatitis B (CHB), specifically targeting patients in the immune tolerance phase. The combination consists of entecavir, a guanosine nucleoside analogue, and tenofovir amibufenamide (HS-10234), a novel oral prodrug of the nucleotide reverse transcriptase inhibitor tenofovir. Entecavir works by inhibiting the HBV DNA polymerase through competition with the natural substrate deoxyguanosine triphosphate. Tenofovir amibufenamide is designed for high plasma stability and efficient delivery of the active metabolite to hepatocytes, which allows for lower dosing and reduced systemic exposure compared to older tenofovir formulations, thereby minimizing potential bone and renal toxicities. This dual-therapy approach, evaluated in clinical trials led by Sun Yat-sen University, aims to achieve superior viral suppression and higher rates of HBeAg seroconversion compared to standard monotherapy.
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