Therapeutic efficacy of hepatitis B virus vaccine in treatment of chronic HBV infections: A systematic review and meta‐analysis. (6th December 2019)

• Record Type: Journal Article
• Authors: Ghozy, Sherief; Nam, Nguyen Hai; Radwan, Ibrahim; Karimzadeh, Sedighe; Tieu, Thuan Minh; Hashan, Mohammad Rashidul; Abbas, Alzhraa Salah; Eid, Peter Samuel; Vuong, Nguyen Lam; Khang, Nguyen Vinh; Elgabalawy, Eman; Sayed, Ahmed Kamal; Hoa, Pham Thi Le; Huy, Nguyen Tien
• Is Part Of: Reviews in medical virology. Volume 30:Number 3(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-12-06
• Subjects: analogue monotherapy -- chronic hepatitis B -- combination therapy -- HBeAg loss -- HBeAg seroconversion -- nucleotide analogues -- vaccine monotherapy; Medical virology -- Periodicals; Review Literature -- Periodicals; Virus Diseases -- Periodicals; Viruses -- Periodicals; 616.0194
• DOI: 10.1002/rmv.2089
• Languages: English
• ISSNs: 1052-9276

Abstract

Summary: There is a need for improved treatment of patients with chronic hepatitis B (CHB). We reviewed the literature to explore the efficacy of HB vaccines alone or in combination therapy (CT) with antiviral drugs in CHB patients and to meta‐analyze data from randomized controlled trials. We conducted a systematic search in ten databases. All studies investigating the efficacy of HBV vaccine in HBV infected patients were included with no restrictions. Among 1359 studies initially identified, 23 studies ( n = 1956 patients) were included for the final analysis. CT showed a significant reduction of HBV DNA compared with analogue monotherapy (AM) at the 12‐month follow‐up period (odds ratio (OR) = 2.835, 95% confidence interval (CI) [1.275, 6.306], p = .011). Additionally, CT also remarkably induce HbsAg loss in comparison with AM (OR = 11.736, 95% CI [1.841, 74.794], p = .009). Our pooled data revealed no difference between treatment and control regarding alanine aminotransferase normalization, HBeAg seroconversion, and HBeAg disappearance. In addition, CT using vaccine and NAs resulted in a statistically significant higher incidence of adverse effects than AM. The therapeutic effects of combination therapy for patients with CHB were encouraging, but future studies need to investigate all possible treatment combinations and assess their cost‐effectiveness.