entecavir + tenofovir alafenamide

Entecavir plus tenofovir alafenamide is a combination therapy used for the treatment of chronic hepatitis B (CHB), particularly in patients with previous nucleos(t)ide treatment failure or multidrug-resistant HBV strains. This combination leverages two potent antiviral agents with non-overlapping resistance profiles. Entecavir is a guanosine nucleoside analog that inhibits HBV DNA polymerase, while tenofovir alafenamide is a prodrug of tenofovir that delivers the active metabolite more efficiently to hepatocytes with reduced systemic exposure compared to tenofovir disoproxil fumarate. The combination therapy has shown efficacy in achieving virologic suppression in patients with resistance to other antivirals.