Rev Med Virol. 2019 Dec 6:e2089. doi: 10.1002/rmv.2089. [Epub ahead of print]
Therapeutic efficacy of hepatitis B virus vaccine in treatment of chronic HBV infections: A systematic review and meta-analysis.
Ghozy S1,2, Nam NH2,3, Radwan I2,4, Karimzadeh S2,5, Tieu TM2,6, Hashan MR2,7, Abbas AS2,8, Eid PS2,4, Vuong NL2,9, Khang NV2,10, Elagabalawy E2,4, Kamal A11, Hoa PTL12, Huy NT13,14,15.
Author information
1
Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt.
2
Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan.
3
Department of General Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
4
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
5
School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
6
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
7
Respiratory and Enteric Infections Department, Infectious Disease Division, International Centre for Diarrheal Disease and Research, Dhaka, Bangladesh.
8
Department of Anesthesia, Al-Ahrar Teaching Hospital, Zagazig, Egypt.
9
Department of Medical Statistics and Informatics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
10
Department of Neurology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
11
Faculty of Medicine, Minia University, Minia, Egypt.
12
Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
13
Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
14
Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
15
Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Abstract
There is a need for improved treatment of patients with chronic hepatitis B (CHB). We reviewed the literature to explore the efficacy of HB vaccines alone or in combination therapy (CT) with antiviral drugs in CHB patients and to meta-analyze data from randomized controlled trials. We conducted a systematic search in ten databases. All studies investigating the efficacy of HBV vaccine in HBV infected patients were included with no restrictions. Among 1359 studies initially identified, 23 studies (n = 1956 patients) were included for the final analysis. CT showed a significant reduction of HBV DNA compared with analogue monotherapy (AM) at the 12-month follow-up period (odds ratio (OR) = 2.835, 95% confidence interval (CI) [1.275, 6.306], p = .011). Additionally, CT also remarkably induce HbsAg loss in comparison with AM (OR = 11.736, 95% CI [1.841, 74.794], p = .009). Our pooled data revealed no difference between treatment and control regarding alanine aminotransferase normalization, HBeAg seroconversion, and HBeAg disappearance. In addition, CT using vaccine and NAs resulted in a statistically significant higher incidence of adverse effects than AM. The therapeutic effects of combination therapy for patients with CHB were encouraging, but future studies need to investigate all possible treatment combinations and assess their cost-effectiveness.