Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials
<p>Abstract</p> <p>Background</p> <p>Interferon alpha (IFNα) therapy has been widely used in the treatment of chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also increasingly used to treat CHB recently. More and more studies are being carried out con...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-06-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2334/11/165 |
| _version_ | 1818082774369697792 |
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| author | Zhang Yu-guo Ren Wei-guang Kong Ling-bo Wang Mao-rong Li Wen-cong Nan Yue-min |
| author_facet | Zhang Yu-guo Ren Wei-guang Kong Ling-bo Wang Mao-rong Li Wen-cong Nan Yue-min |
| author_sort | Zhang Yu-guo |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Interferon alpha (IFNα) therapy has been widely used in the treatment of chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also increasingly used to treat CHB recently. More and more studies are being carried out concerning the clearance or seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy. This study conducted a meta-analysis to estimate the effect of pegylated interferon alpha (peginterferon α, PEG-IFNα)-based therapy on HBsAg clearance or seroconversion in CHB.</p> <p>Methods</p> <p>All available controlled clinical trials, published from 2004 to 2010, with the following antiviral therapies for CHB patients: PEG-IFNα combined with lamivudine (LAM), PEG-IFNα only, conventional IFNα and LAM, with a course ≥24 weeks, were meta-analysed for HBsAg clearance and seroconversion.</p> <p>Results</p> <p>Fourteen trials (involving a total of 2,682 patients) were identified, including seven high-quality and seven low-quality studies. The analysis results of the different antiviral therapies on HBsAg clearance or seroconversion were as follows: 1. No significant difference in HBsAg clearance or seroconversion was observed between the combination therapy group and PEG-IFNα monotherapy group [odds ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), <it>P </it>= 0.54 and OR = 1.07, 95% CI (0.58-1.97), <it>P </it>= 0.82, respectively]; 2. HBsAg clearance and seroconversion rates in patients with combination therapy were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI (1.18-74.94), <it>P </it>= 0.03, and OR = 12.37, 95% CI (1.60-95.44), <it>P </it>= 0.02, respectively]; 3. There was significant difference in HBsAg clearance between the PEG-IFNα group and IFNα monotherapy group [OR = 4.95, 95% CI (1.23-20.00), <it>P </it>= 0.02], but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), <it>P </it>= 0.37]; 4. PEG-IFNα was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI (1.91-111.49), <it>P </it>= 0.01].</p> <p>Conclusions</p> <p>PEG-IFNα facilitated HBsAg clearance or seroconversion in CHB patients. PEG-IFNα-based therapy was more effective than LAM monotherapy in achieving HBsAg clearance or seroconversion for both HBeAg-positive and HBeAg-negative CHB patients. There was no significant difference in HBsAg clearance or seroconversion between PEG-IFNα/LAM combination therapy and PEG-IFNα monotherapy. PEG-IFNα was obviously superior to conventional IFNα in HBsAg clearance, but not in HBsAg seroconversion. Although PEG-IFNα produced significantly higher rates of HBsAg clearance and seroconversion, the absolute change in the proportion of HBsAg clearance and seroconversion was low (about 3-6%). Therefore, additional interventions are needed to improve the rate of positive outcomes.</p> |
| first_indexed | 2024-12-10T19:27:26Z |
| format | Article |
| id | doaj.art-d54d163bff7c4064b1d497351e8a25e3 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-10T19:27:26Z |
| publishDate | 2011-06-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-d54d163bff7c4064b1d497351e8a25e32022-12-22T01:36:20ZengBMCBMC Infectious Diseases1471-23342011-06-0111116510.1186/1471-2334-11-165Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trialsZhang Yu-guoRen Wei-guangKong Ling-boWang Mao-rongLi Wen-congNan Yue-min<p>Abstract</p> <p>Background</p> <p>Interferon alpha (IFNα) therapy has been widely used in the treatment of chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also increasingly used to treat CHB recently. More and more studies are being carried out concerning the clearance or seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy. This study conducted a meta-analysis to estimate the effect of pegylated interferon alpha (peginterferon α, PEG-IFNα)-based therapy on HBsAg clearance or seroconversion in CHB.</p> <p>Methods</p> <p>All available controlled clinical trials, published from 2004 to 2010, with the following antiviral therapies for CHB patients: PEG-IFNα combined with lamivudine (LAM), PEG-IFNα only, conventional IFNα and LAM, with a course ≥24 weeks, were meta-analysed for HBsAg clearance and seroconversion.</p> <p>Results</p> <p>Fourteen trials (involving a total of 2,682 patients) were identified, including seven high-quality and seven low-quality studies. The analysis results of the different antiviral therapies on HBsAg clearance or seroconversion were as follows: 1. No significant difference in HBsAg clearance or seroconversion was observed between the combination therapy group and PEG-IFNα monotherapy group [odds ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), <it>P </it>= 0.54 and OR = 1.07, 95% CI (0.58-1.97), <it>P </it>= 0.82, respectively]; 2. HBsAg clearance and seroconversion rates in patients with combination therapy were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI (1.18-74.94), <it>P </it>= 0.03, and OR = 12.37, 95% CI (1.60-95.44), <it>P </it>= 0.02, respectively]; 3. There was significant difference in HBsAg clearance between the PEG-IFNα group and IFNα monotherapy group [OR = 4.95, 95% CI (1.23-20.00), <it>P </it>= 0.02], but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), <it>P </it>= 0.37]; 4. PEG-IFNα was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI (1.91-111.49), <it>P </it>= 0.01].</p> <p>Conclusions</p> <p>PEG-IFNα facilitated HBsAg clearance or seroconversion in CHB patients. PEG-IFNα-based therapy was more effective than LAM monotherapy in achieving HBsAg clearance or seroconversion for both HBeAg-positive and HBeAg-negative CHB patients. There was no significant difference in HBsAg clearance or seroconversion between PEG-IFNα/LAM combination therapy and PEG-IFNα monotherapy. PEG-IFNα was obviously superior to conventional IFNα in HBsAg clearance, but not in HBsAg seroconversion. Although PEG-IFNα produced significantly higher rates of HBsAg clearance and seroconversion, the absolute change in the proportion of HBsAg clearance and seroconversion was low (about 3-6%). Therefore, additional interventions are needed to improve the rate of positive outcomes.</p>http://www.biomedcentral.com/1471-2334/11/165hepatitis BHBsAgpeginterferoninterferonlamivudine |
| spellingShingle | Zhang Yu-guo Ren Wei-guang Kong Ling-bo Wang Mao-rong Li Wen-cong Nan Yue-min Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials BMC Infectious Diseases hepatitis B HBsAg peginterferon interferon lamivudine |
| title | Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials |
| title_full | Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials |
| title_fullStr | Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials |
| title_full_unstemmed | Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials |
| title_short | Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials |
| title_sort | peginterferon alpha based therapy for chronic hepatitis b focusing on hbsag clearance or seroconversion a meta analysis of controlled clinical trials |
| topic | hepatitis B HBsAg peginterferon interferon lamivudine |
| url | http://www.biomedcentral.com/1471-2334/11/165 |
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