Pegylated interferon alfa for chronic hepatitis B: systematic review and meta‐analysis |
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Authors: | V. Kim R. M. Abreu D. M. Nakagawa R. M. Baldassare F. J. Carrilho S. K. Ono |
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Affiliation: | Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of S?o Paulo School of Medicine, S?o Paulo, Brazil |
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Abstract: | 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. |
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Keywords: | chronic hepatitis B meta‐analysis pegylated interferon alfa randomized controlled trials |
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