Year 2016 / Volume 108 / Number 5
Original
HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

263-270

DOI: 10.17235/reed.2016.3995/2015

Yun Zhang, Bangtao Chen, Lin Wang, Junjie Chi, Shaojuan Song, Mingshe Liu, Zhongfu Zhao,

Abstract
Background and aims: Seroclearance or seroconversion of hepatitis B surface antigen (HBsAg) is generally considered as the clinical endpoint. The purpose of the present meta-analysis was to evaluate pegylated interferon alpha (PEG-IFNα) with or without lamivudine (LAM) or adefovir (ADV) combination treatment in HBsAg seroclearance or seroconversion with CHB. Methods: Randomized controlled trials of adults with CHB prior to May 30th 2015, with 48-52 weeks of PEG-IFNα and LAM or ADV combination therapy or monotherapy, were included. Review Manager Software 5.2.0 was used for meta-analysis. Results: No statistical difference was noticed in HBsAg seroclearance (9.9% vs 7.1%, OR = 1.47, 95% CI 0.75, 2.90; p = 0.26) or observed in HBsAg seroconversion (4.2% vs 3.7%, OR = 1.17, 95% CI 0.57, 2.37; p = 0.67) between PEG-IFNα + LAM and PEG-IFNα + placebo for 24-26 weeks follow-up after treatment on hepatitis B e antigen (HBeAg)-positive CHB. Statistical difference was not showed in HBsAg disappearance (10.5% vs 6.4%, OR = 1.68, 95% CI 0.75, 3.76; p = 0.21) but was demonstrated in HBsAg seroconversion (6.3% vs 0%, OR = 7.22, 95% CI 1.23, 42.40; p = 0.03) between PEG-IFNα + ADV and PEG-IFNα for 48-52 weeks treatment on HBeAg-positive CHB By systematical evaluation, there were no differences in HBsAg disappearance and seroconversion between PEG-IFNα + placebo and PEG-IFNα + LAM for 48-52 weeks treatment on HBeAg-positive CHB. There were no differences in HBsAg disappearance and seroconversion between PEG-IFNα + placebo and PEG-IFNα + LAM during 24 weeks to 3 years follow-up after treatment on HBeAg-negative CHB by systematical evaluation. Conclusion: The combination between PEG-IFNα and LAM or ADV was not superior to monotherapy of PEG-IFNα in terms of HBsAg seroclearance or seroconversion
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References
1 Lavanchy D. Hepatitis B Virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004; 11:97–107.
2 Lok ASF, Mcmahon BJ. AASLD guidelines. Chronic hepatitis B: update 2009.Hepatology 2009;50:661–2.
3 European Association for the Study of the Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012;57:167–85.
4 Li WC, Wang MR, Kong LB, et al. Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials. BMC Infect Dis 2011;11:165.
5 Huang R, Hao Y, Zhang J, et al. Interferon-alpha plus adefovir combination therapy versus interferon-alpha monotherapy for chronic hepatitis B treatment: A meta-analysis. Hepatol Res 2013; 43: 1040–51.
6 Jadad AR, Moore RA, Carroll D, et al: Assessing the quality of reports of randomized clinical trials:is blinding necessary? Control Clin Trials 1996; 17:1-12.
7 AO FJ, Ma WM, Zhou BP,et al. Comparison of efficacy and safety of pegylated interferon alfa-2a or adefovir dipivoxil monotherapy with combination therapy in HBeAg positive chronic hepatitis B patients. Chin J Infect Dis 2010;28:214-7.
8 Ding WM. Twenty-two chronic hepatitis B patients treated with pegylated interferon and adefovir dipivoxil. Chin J Mod Drug Appl 2010;4:164-5.
9 Liu YH, Wu T, Sun N, et al. Combination Therapy with Pegylated Interferon alpha-2b and Adefovir Dipivoxil in HBeAg-positive Chronic Hepatitis B versus Interferon Alone: A Prospective, Randomized Study. J Huazhong Univ Sci Technolog Med Sci. 2014;34:542-7.
10 Chen HO, Liu HJ, Hu XX. Efficacy of adefovir dipivoxil combined with pegylated interferon alfa-2a in treatment of chronic hepatitis B patients with high levels virus load. Chin J Gastroenterol Hepatol 2013;22:456-8.
11 Li WB,Ding JG,Sun QF ,et al.Efficacy of pegylated interferon alfa-2a combined with adefovir dipivoxil in treatment of HBeAg positive chronic hepatitis B. Chin J Nosocomiol 2013;23:1250-2.
12 Liang JP, Zhang XM,Xia J ,et al. Clinical efficacy of interferons combined with adefovir dipivoxil in treatment of chronic hepatitis B. Chin J Nosocomiol 2013;23:3498-500.
13 Han SY, Rong G, Wang Y. Therapeutic effect of pegylated interferon alpha-2a combined with adefovir dipivoxil in the treatment of HBeAg-positive chronic hepatitis B. China Prac Med 2014;9:1-2.
14 Janssen HL, van Zonneveld M, Senturk H, et al. HBV 99-01 Study Group; Rotterdam Foundation for Liver Research: Pegylated interferon alfa-2b alone or in combination with lamivudine for HBeAg-positive chronic hepatitis B: a randomized trial. Lancet 2005;365:123-9.
15 Lau GK, Piratvisuth T, Luo KX, et al. Peginterferon Alfa-2a HBeAg-Positive Chronic Hepatitis B Study Group: Peginterferon alfa-2a, Lamivudine, and the combination for HBeAg-positive chronic hepatitis B. N Engl J Med 2005;352:2682-95.
16 Buster EH, Flink HJ, Cakaloglu Y, et al. Sustained HBeAg and HBsAg Loss after Longterm Follow-up of HBeAg-Positive Patients Treated With Peginterferon α-2b. Gastroenterology 2008;135:459-67.
17 Piccolo P, Lenci I, Demelia L, et al. A randomized controlled trial of pegylated interferon-(alpha)2a plus adefovir dipivoxil for hepatitis B e antigen-negative chronic hepatitis B. Antivir Ther 2009; 14:1165–74.
18 Marcellin P, Lau GK, Bonino F, et al. Peginterferon Alfa-2a HBeAg-Negative Chronic Hepatitis B Study Group: Peginterferon alfa-2a alone, Lamivudine alone, and the two in combination in patients with HBeAg-negative chronic hepatitis B.N Engl J Med 2004;351:1206-17.
19 Marcellin P, Bonino F, Lau GK, et al. Peginterferon alfa-2a in HBeAg-negative Chronic Hepatitis B Study Group: Sustained Response of Hepatitis B e Antigen-Negative Patients 3 Years After Treatment with Peginterferon Alfa-2a. Gastroenterology 2009;136:2169-79.
20 Kaymakoglu S,Oguz D,Gur G, et al. Pegylated Interferon Alfa-2b Monotherapy and Pegylated Interferon Alfa-2b plus Lamivudine Combination Therapy for Patients with Hepatitis B Virus E Antigen-Negative Chronic Hepatitis B. Antimicrob Agents Chemother 2007;51:3020-2.
21 Gish RG,Chang TT,Lai CL, et al. Loss of HBsAg antigen during treatment with entecavir or lamivudine in nucleoside-naive HBeAg-positive patients with chronic hepatitis B. J Viral Hepat 2010;17:16 -22 .
22 Chang TT, Lai CL, KewYoon S, et al. Entecavir treatment for up to 5 years in patients with hepatitis B e antigen-positive chronic hepatitis B. Hepatology 2010;51:422–30.
23 Heathcote EJ, Marcellin P, Buti M, et al. Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B. Gastroenterology 2011;140:132–43.
24 Heathcote EJ, Gane EJ, deMan RA. Long term (4 year) efficacy and safety of tenofovir disoproxil fumarate (TDF) treatment in HBeAg-positive patients (HBeAg+) with chronic hepatitis B (Study 103): preliminary results. Hepatology 2010 ; 52:556A (abstract 477) .
25 Boni C, Laccabue D, Lampertico P, et al. Restored function of HBV-specific T cells after long-term effective therapy with nucleos(t)ide analogues. Gastroenterology 2012;143:963-73.
26 Zhang JY, Song CH, Shi F, et al. Decreased ratio of Treg cells to Th17 cells correlates with HBV DNA suppression in chronic hepatitis B patients undergoing entecavir treatment. PLoS One 2010;5:e13869
27 Lin C, Zou H, Wang S. Hepatitis B e Antigen  Seroconversion  Is Related with the Function of Dendritic Cells in Chronic Hepatitis B Virus Infection. Gastroenterol Res Pract 2014;2014:413952.
28 Yan W, Wu D, Wang X, et al. Upregulation of NKG2C(+) natural killer cells, TLR-2 expression on monocytes and downregulation of regulatory T-cells influence PEG-IFN treatment efficacy in entecavir -suppressed patients with CHB. Antivir Ther 2015;20:591-602.
29 Boni C, Lampertico P, Talamona L, et al. Natural killer cell phenotype modulation and natural killer/T-cell interplay in nucleos(t)ide analogue-treated hepatitis e antigen-negative patients with chronic hepatitis B. Hepatology 2015;62:1697-709.
30 Stelma F, de Niet A, Tempelmans Plat-Sinnige MJ, et al. Natural Killer Cell Characteristics in Patients With Chronic Hepatitis B Virus (HBV) Infection Are Associated With HBV Surface Antigen Clearance After Combination Treatment With Pegylated Interferon Alfa-2a and Adefovir. J Infect Dis 2015;212:1042-51.
31 Xu X, Shang Q, Chen X, et al. Reversal of B-cell hyperactivation and functional impairment is associated with HBsAg seroconversion in chronic hepatitis B patients. Cell Mol Immunol 2015; 12:309-16.
32 Qu LS, Liu JX, Zhang HF ,et al. Effect of serum hepatitis B surface antigen levels on predicting the clinical outcomes of chronic hepatitis B infection: A meta-analysis. Hepatol Res 2014 Oct 30.
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Zhang Y, Chen B, Wang L, Chi J, Song S, Liu M, et all. HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review. 3995/2015


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Publication history

Received: 03/09/2015

Accepted: 17/03/2016

Online First: 29/03/2016

Published: 29/04/2016

Article revision time: 192 days

Article Online First time: 208 days

Article editing time: 239 days


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