Efficacy and safety of antiviral therapy in chronic hepatitis B virus carriers
Objective:To investigate the efficacy and safety of antiviral therapy in chronic hepatitis B virus carriers(CHBVCs)through a systematical review by searching the databases in China and globally.Methods:PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP,and CMB were searched for randomized controlled clinical trials or cohort studies on antiviral therapy for CHBVC,with the regimens of nucleos(t)ide analogue(NA)alone,interferon-α(IFNα)alone,and NA combined with IFNα,and Stata17 was used to perform the meta-analysis.Results:A total of 28 articles were included,involving 1623 CHBVCs who received antiviral therapy.As for the analysis of efficacy,serum HBsAg clearance rate was 20％(338/1421),and the HBeAg negative group had an HBsAg clearance rate as high as 52.9％,while the HBeAg positive group had a clearance of 1.5％;in the HBeAg negative group,the HBV DNA＜2000 IU/mL group had an HBsAg clearance rate of 45.6％,while the HBV DNA＜20 IU/mL group had an HBsAg clearance rate of 59.9％.The HBsAg seroconversion rate was 15.3％(196/946),and the HBeAg negative group had a relatively high HBsAg seroconversion rate of 38.2％,while no significant change was observed in the HBeAg positive group;in the HBeAg negative group,the HBV DNA＜2000 IU/mL group had an HBsAg seroconversion rate of 34.5％,while the HBV DNA＜20 IU/mL group had an HBsAg seroconversion rate of 49.4％.The serum HBeAg clearance rate was 6.6％(34/465),which gradually increased over the course of treatment and reached 8.8％at week 192.The HBeAg seroconversion rate was 8％(63/700),with the highest rate of 24％at week 96,and the combination of NA and IFNα was superior to NA alone(8.1％vs.5.4％).The overall serum HBV DNA clearance rate reached 70.1％(500/738).In the analysis of safety,a statistical analysis of adverse events was performed among 494 patients in 8 articles,and the results showed that the overall incidence rate of adverse events was about 5.4％(28/494).Conclusion:Antiviral therapy has good efficacy and safety in CHBVCs,and the NA+IFNαregimen and the long-term treatment regimen have significant benefits in CHBVCs.
chronic hepatitis B virus carriersantiviral therapynucleos(t)ide analogueinterferon-αmeta-analysis
万方数据
维普
