Pegylated interferon alfa for chronic hepatitis B: systematic review and meta-analysis

Summary Conventional interferon alfa and nucleos(t)ide analogues, such as lamivudine, are frequently used for chronic hepatitis B (CHB) treatment, but are associated with adverse effects and viral resistance. Here we performed a systematic review and meta‐analysis evaluating all studies of pegylated...

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Bibliographic Details
Published in:Journal of viral hepatitis 2016-03, Vol.23 (3), p.154-169
Main Authors: Kim, V., Abreu, R. M., Nakagawa, D. M., Baldassare, R. M., Carrilho, F. J., Ono, S. K.
Format: Article
Language:English
Subjects:
Adenine - analogs & derivatives
Adenine - therapeutic use
Antiviral Agents - therapeutic use
chronic hepatitis B
Drug Therapy, Combination - methods
Hepatitis B e Antigens - blood
Hepatitis B, Chronic - drug therapy
Humans
Interferon-alpha - therapeutic use
Lamivudine - therapeutic use
meta-analysis
Organophosphonates - therapeutic use
pegylated interferon alfa
randomized controlled trials
Randomized Controlled Trials as Topic
Treatment Outcome
Viral Load
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Summary:Summary Conventional interferon alfa and nucleos(t)ide analogues, such as lamivudine, are frequently used for chronic hepatitis B (CHB) treatment, but are associated with adverse effects and viral resistance. Here we performed a systematic review and meta‐analysis evaluating all studies of pegylated interferon alfa (PEG‐IFNα) treatment in hepatitis B e antigen (HBeAg)‐positive and HBeAg‐negative patients with CHB. We searched electronic databases – PubMed, EMBASE, Cochrane Library and LILACS – for randomized controlled trials evaluating PEG‐IFNα therapy between 1999 and September 2014. Virological response was the primary outcome. We identified 14 studies involving 2829 patients. Our analysis revealed that PEG‐IFNα + lamivudine combination therapy produced better virological and biochemical responses than PEG‐IFNα monotherapy in HBeAg‐positive and HBeAg‐negative patients at the end of treatment. PEG‐IFNα + adefovir dipivoxil achieved better seroconversion rate than PEG‐IFNα in HBeAg‐positive patients at the end of treatment. The present findings demonstrated a beneficial response rate following PEG‐IFNα combination therapy with nucelos(t)ides among HBeAg‐positive and HBeAg‐negative patients with CHB. Further trials are needed to investigate simultaneous and sequential therapy strategies.
ISSN:1352-0504
1365-2893
DOI:10.1111/jvh.12418