Año 2016 / Volumen 108 / Número 5
Original
HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

263-270

DOI: 10.17235/reed.2016.3995/2015

Yun Zhang, Bangtao Chen, Lin Wang, Junjie Chi, Shaojuan Song, Mingshe Liu, Zhongfu Zhao,

Resumen
Background and aims: Seroclearance or seroconversion of hepatitis B surface antigen (HBsAg) is generally considered as the clinical endpoint. The purpose of the present meta-analysis was to evaluate pegylated interferon alpha (PEG-IFNα) with or without lamivudine (LAM) or adefovir (ADV) combination treatment in HBsAg seroclearance or seroconversion with CHB. Methods: Randomized controlled trials of adults with CHB prior to May 30th 2015, with 48-52 weeks of PEG-IFNα and LAM or ADV combination therapy or monotherapy, were included. Review Manager Software 5.2.0 was used for meta-analysis. Results: No statistical difference was noticed in HBsAg seroclearance (9.9% vs 7.1%, OR = 1.47, 95% CI 0.75, 2.90; p = 0.26) or observed in HBsAg seroconversion (4.2% vs 3.7%, OR = 1.17, 95% CI 0.57, 2.37; p = 0.67) between PEG-IFNα + LAM and PEG-IFNα + placebo for 24-26 weeks follow-up after treatment on hepatitis B e antigen (HBeAg)-positive CHB. Statistical difference was not showed in HBsAg disappearance (10.5% vs 6.4%, OR = 1.68, 95% CI 0.75, 3.76; p = 0.21) but was demonstrated in HBsAg seroconversion (6.3% vs 0%, OR = 7.22, 95% CI 1.23, 42.40; p = 0.03) between PEG-IFNα + ADV and PEG-IFNα for 48-52 weeks treatment on HBeAg-positive CHB By systematical evaluation, there were no differences in HBsAg disappearance and seroconversion between PEG-IFNα + placebo and PEG-IFNα + LAM for 48-52 weeks treatment on HBeAg-positive CHB. There were no differences in HBsAg disappearance and seroconversion between PEG-IFNα + placebo and PEG-IFNα + LAM during 24 weeks to 3 years follow-up after treatment on HBeAg-negative CHB by systematical evaluation. Conclusion: The combination between PEG-IFNα and LAM or ADV was not superior to monotherapy of PEG-IFNα in terms of HBsAg seroclearance or seroconversion
Share Button
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1 Lavanchy D. Hepatitis B Virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004; 11:97–107.
2 Lok ASF, Mcmahon BJ. AASLD guidelines. Chronic hepatitis B: update 2009.Hepatology 2009;50:661–2.
3 European Association for the Study of the Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012;57:167–85.
4 Li WC, Wang MR, Kong LB, et al. Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials. BMC Infect Dis 2011;11:165.
5 Huang R, Hao Y, Zhang J, et al. Interferon-alpha plus adefovir combination therapy versus interferon-alpha monotherapy for chronic hepatitis B treatment: A meta-analysis. Hepatol Res 2013; 43: 1040–51.
6 Jadad AR, Moore RA, Carroll D, et al: Assessing the quality of reports of randomized clinical trials:is blinding necessary? Control Clin Trials 1996; 17:1-12.
7 AO FJ, Ma WM, Zhou BP,et al. Comparison of efficacy and safety of pegylated interferon alfa-2a or adefovir dipivoxil monotherapy with combination therapy in HBeAg positive chronic hepatitis B patients. Chin J Infect Dis 2010;28:214-7.
8 Ding WM. Twenty-two chronic hepatitis B patients treated with pegylated interferon and adefovir dipivoxil. Chin J Mod Drug Appl 2010;4:164-5.
9 Liu YH, Wu T, Sun N, et al. Combination Therapy with Pegylated Interferon alpha-2b and Adefovir Dipivoxil in HBeAg-positive Chronic Hepatitis B versus Interferon Alone: A Prospective, Randomized Study. J Huazhong Univ Sci Technolog Med Sci. 2014;34:542-7.
10 Chen HO, Liu HJ, Hu XX. Efficacy of adefovir dipivoxil combined with pegylated interferon alfa-2a in treatment of chronic hepatitis B patients with high levels virus load. Chin J Gastroenterol Hepatol 2013;22:456-8.
11 Li WB,Ding JG,Sun QF ,et al.Efficacy of pegylated interferon alfa-2a combined with adefovir dipivoxil in treatment of HBeAg positive chronic hepatitis B. Chin J Nosocomiol 2013;23:1250-2.
12 Liang JP, Zhang XM,Xia J ,et al. Clinical efficacy of interferons combined with adefovir dipivoxil in treatment of chronic hepatitis B. Chin J Nosocomiol 2013;23:3498-500.
13 Han SY, Rong G, Wang Y. Therapeutic effect of pegylated interferon alpha-2a combined with adefovir dipivoxil in the treatment of HBeAg-positive chronic hepatitis B. China Prac Med 2014;9:1-2.
14 Janssen HL, van Zonneveld M, Senturk H, et al. HBV 99-01 Study Group; Rotterdam Foundation for Liver Research: Pegylated interferon alfa-2b alone or in combination with lamivudine for HBeAg-positive chronic hepatitis B: a randomized trial. Lancet 2005;365:123-9.
15 Lau GK, Piratvisuth T, Luo KX, et al. Peginterferon Alfa-2a HBeAg-Positive Chronic Hepatitis B Study Group: Peginterferon alfa-2a, Lamivudine, and the combination for HBeAg-positive chronic hepatitis B. N Engl J Med 2005;352:2682-95.
16 Buster EH, Flink HJ, Cakaloglu Y, et al. Sustained HBeAg and HBsAg Loss after Longterm Follow-up of HBeAg-Positive Patients Treated With Peginterferon α-2b. Gastroenterology 2008;135:459-67.
17 Piccolo P, Lenci I, Demelia L, et al. A randomized controlled trial of pegylated interferon-(alpha)2a plus adefovir dipivoxil for hepatitis B e antigen-negative chronic hepatitis B. Antivir Ther 2009; 14:1165–74.
18 Marcellin P, Lau GK, Bonino F, et al. Peginterferon Alfa-2a HBeAg-Negative Chronic Hepatitis B Study Group: Peginterferon alfa-2a alone, Lamivudine alone, and the two in combination in patients with HBeAg-negative chronic hepatitis B.N Engl J Med 2004;351:1206-17.
19 Marcellin P, Bonino F, Lau GK, et al. Peginterferon alfa-2a in HBeAg-negative Chronic Hepatitis B Study Group: Sustained Response of Hepatitis B e Antigen-Negative Patients 3 Years After Treatment with Peginterferon Alfa-2a. Gastroenterology 2009;136:2169-79.
20 Kaymakoglu S,Oguz D,Gur G, et al. Pegylated Interferon Alfa-2b Monotherapy and Pegylated Interferon Alfa-2b plus Lamivudine Combination Therapy for Patients with Hepatitis B Virus E Antigen-Negative Chronic Hepatitis B. Antimicrob Agents Chemother 2007;51:3020-2.
21 Gish RG,Chang TT,Lai CL, et al. Loss of HBsAg antigen during treatment with entecavir or lamivudine in nucleoside-naive HBeAg-positive patients with chronic hepatitis B. J Viral Hepat 2010;17:16 -22 .
22 Chang TT, Lai CL, KewYoon S, et al. Entecavir treatment for up to 5 years in patients with hepatitis B e antigen-positive chronic hepatitis B. Hepatology 2010;51:422–30.
23 Heathcote EJ, Marcellin P, Buti M, et al. Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B. Gastroenterology 2011;140:132–43.
24 Heathcote EJ, Gane EJ, deMan RA. Long term (4 year) efficacy and safety of tenofovir disoproxil fumarate (TDF) treatment in HBeAg-positive patients (HBeAg+) with chronic hepatitis B (Study 103): preliminary results. Hepatology 2010 ; 52:556A (abstract 477) .
25 Boni C, Laccabue D, Lampertico P, et al. Restored function of HBV-specific T cells after long-term effective therapy with nucleos(t)ide analogues. Gastroenterology 2012;143:963-73.
26 Zhang JY, Song CH, Shi F, et al. Decreased ratio of Treg cells to Th17 cells correlates with HBV DNA suppression in chronic hepatitis B patients undergoing entecavir treatment. PLoS One 2010;5:e13869
27 Lin C, Zou H, Wang S. Hepatitis B e Antigen  Seroconversion  Is Related with the Function of Dendritic Cells in Chronic Hepatitis B Virus Infection. Gastroenterol Res Pract 2014;2014:413952.
28 Yan W, Wu D, Wang X, et al. Upregulation of NKG2C(+) natural killer cells, TLR-2 expression on monocytes and downregulation of regulatory T-cells influence PEG-IFN treatment efficacy in entecavir -suppressed patients with CHB. Antivir Ther 2015;20:591-602.
29 Boni C, Lampertico P, Talamona L, et al. Natural killer cell phenotype modulation and natural killer/T-cell interplay in nucleos(t)ide analogue-treated hepatitis e antigen-negative patients with chronic hepatitis B. Hepatology 2015;62:1697-709.
30 Stelma F, de Niet A, Tempelmans Plat-Sinnige MJ, et al. Natural Killer Cell Characteristics in Patients With Chronic Hepatitis B Virus (HBV) Infection Are Associated With HBV Surface Antigen Clearance After Combination Treatment With Pegylated Interferon Alfa-2a and Adefovir. J Infect Dis 2015;212:1042-51.
31 Xu X, Shang Q, Chen X, et al. Reversal of B-cell hyperactivation and functional impairment is associated with HBsAg seroconversion in chronic hepatitis B patients. Cell Mol Immunol 2015; 12:309-16.
32 Qu LS, Liu JX, Zhang HF ,et al. Effect of serum hepatitis B surface antigen levels on predicting the clinical outcomes of chronic hepatitis B infection: A meta-analysis. Hepatol Res 2014 Oct 30.
Instrucciones para citar
Zhang Y, Chen B, Wang L, Chi J, Song S, Liu M, et all. HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review. 3995/2015


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 596 veces.
Este artículo ha sido descargado 101 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 03/09/2015

Aceptado: 17/03/2016

Prepublicado: 29/03/2016

Publicado: 29/04/2016

Tiempo de revisión del artículo: 192 días

Tiempo de prepublicación: 208 días

Tiempo de edición del artículo: 239 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2023 y Creative Commons. Revista Española de Enfermedades Digestivas