Effects of IFN monotherapy versus combined therapy on HBeAg seroconversion or seroclearance in HBeAg-positive chronic hepatitis B patients: A meta-analysis. (February 2020)

• Record Type: Journal Article
• Authors: Zhu, Feng; Zhang, Qiongfang; Zhang, Qiongyue; Zhang, Dazhi
• Is Part Of: Microbial pathogenesis. Volume 139(2020)
• Publication Date: 2020-02
• Subjects: Chronic hepatitis B -- Hepatitis B e antigen -- Interferon -- Nucleos(t)ide analogues; Pathogenic microorganisms -- Periodicals; Pathology, Molecular -- Periodicals; Communicable Diseases -- microbiology -- Periodicals; Communicable Diseases -- parasitology -- Periodicals; Micro-organismes pathogènes -- Périodiques; Pathologie moléculaire -- Périodiques; Electronic journals; 616.9041
• DOI: 10.1016/j.micpath.2019.103912
• Languages: English
• ISSNs: 0882-4010

Abstract

Abstract: Background and aims: Recent available treatment guidelines are pointing up clearance or seroconversion of hepatitis B e-antigen (HBeAg) as a valuable endpoint in treating HBeAg-positive chronic hepatitis B (CHB) patients. To evaluate the effect of combination therapy [interferon (IFN) plus nucleos(t)ide analogues (NAs)] versus IFN monotherapy on HBeAg seroconversion or seroclearance in HBeAg-positive CHB patients. Methods: All available controlled clinical studies, published from Jan 2000 to Sep 2018, with CHB receiving IFN and NA combination therapy or IFN monotherapy were included. Risk ratio (RR) and their 95% confidence intervals (CIs) was estimated with a fixed-effects model when I 2 <50% for the test for heterogeneity. Publication bias was measured using Egger's test. Results: Twelve studies were included. Our meta-analysis demonstrated that IFN and NA combination therapy had a superior HBeAg seroconversion rate or clearance rate compared with IFN monotherapy at the end of treatment (EOT). Sub-analysis showed IFN plus adefovir dipivoxi (ADV) therapy had a better HBeAg seroconversion or seroclearance rate at EOT or at the end of follow-up (EOF). Conclusion: Compared with IFN monotherapy, the combined therapy had a higher e-antigen serological response at EOT, but failed to improve the sustained response at EOF. Only combination therapy with IFN and ADV is superior to IFN monotherapy at the EOT or EOF for HBeAg seroconversion or seroclearance in HBeAg-positive CHB patients. The effect of other combination therapies is not superior to IFN monotherapy. Highlights: Interferon plus adefovir is superior to IFN monotherapy for HBeAg response. Combination therapy is superior to Interferon monotherapy at the end of treatment. Interferon plus tenofovir could only improve the HBeAg response for a short time. Interferon plus lamivudine or entecavir has no advantage for HBeAg response.