Treatment of children with HBeAg-positive chronic hepatitis B: A systematic review and meta-analysis |
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Affiliation: | 1. Research Unit, Tanta Fever Hospital, Tanta, Egypt;2. Public Health, Preventive and Social Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt |
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Abstract: | BackgroundEffective management of children with chronic hepatitis B is still an unresolved issue.AimTo assess the outcome of different therapeutic regimens among children with HBeAg-positive chronic hepatitis B.MethodsElectronic database searches identified clinical trials that completed specific periods of treatment and follow-up. Sustained response rates were defined by the loss of HBV DNA and HBeAg, and by the normalization of liver enzymes. The loss of HBsAg and seroconversion to anti-HBs were also listed.ResultsOur searches found 20 eligible articles (1112 enrolled patients, 2–18 years old). Interferon-alpha therapy showed significantly higher sustained response rate and loss of HBsAg than no therapy (Odd's ratio 3.0, 95% confidence interval 1.6–5.4; and 2.3, 1.1–11.3, respectively). The sustained response rate was not significantly different between interferon and interferon plus lamivudine, or plus prednisone, or plus hepatitis B vaccine; this rate was significantly higher for interferon compared with combined interferon plus levamisole or vitamin E.ConclusionInterferon-alpha is still the most effective treatment option for children with HBeAg-positive chronic hepatitis B. Randomized trials are warranted for further comparing interferon to newer antiviral agents in terms of efficacy, safety, emergence of mutant variants, and cost/benefit ratio. |
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Keywords: | Children Chronic hepatitis B Meta-analysis Treatment |
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