First online: 11 July 2015
Response-guided therapy of regimens based on PEG-interferon for chronic hepatitis B using on-treatment hepatitis B surface antigen quantification: a meta-analysis
Hong Peng, Fang Wei, Jun-Ying Liu, Huai-Dong Hu, Hong Ren, Peng Hu
Author Affiliations
1. Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China
2. Department of Infectious Diseases, The Guizhou Province People’s Hospital, Guiyang, Guizhou Province, China
3. Department of Gastroenterology, The Central Hospital of Zhoukou, Zhoukou, Henan Province, China
Abstract
Purpose
The efficacy of on-treatment hepatitis B surface antigen (HBsAg) levels in guiding pegylated interferon (PEG-IFN) therapy for chronic hepatitis B (CHB) infections is still controversial. The aim of this study is to quantitatively evaluate the efficacy of on-treatment HBsAg levels as a response-guided therapy strategy to guide PEG-IFN-based therapies for CHB.
Methods
We searched PUBMED, EMBASE, and the Cochrane Library (1997–2013) for clinical research involving HBsAg quantification, and the response to PEG-IFN-based therapy. Pooled effect of HBsAg levels on guiding PEG-IFN-based therapies for CHB was evaluated using fixed-effects or random-effects model.
Results
From 13 studies (n = 1493 patients), patients with optimal on-treatment HBsAg levels were found to have a greater chance of attaining a response (RR 5.17, 95 % CI 3.75–7.11, p < 0.00001), and the pooled total response rate was 54 % (95 % CI 44–63 %). At week 12, patients without optimal on-treatment HBsAg levels had hardly achieved a response (the early non-response rate: 99 %, 95 % CI 98–100 %). At 24 weeks, the response rate increased to 79 % in HBeAg-negative patients.
Conclusion
This meta-analysis suggested that on-treatment HBsAg quantification is effective in guiding the therapy of PEG-IFN in CHB infections, especially in HBeAg-negative patients.
Keywords
HBV DNA Antiviral treatment Sero conversion Nucleot(s)ide analogs
Electronic supplementary material
The online version of this article (doi:10.1007/s12072-015-9644-y) contains supplementary material, which is available to authorized users.