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标题: 成人HBeAg阳性（免疫耐受患者）慢性感染中乙型肝炎病毒感染 [打印本页]

作者: StephenW 时间: 2021-4-7 09:59 标题: 成人HBeAg阳性（免疫耐受患者）慢性感染中乙型肝炎病毒感染

Treatment of hepatitis B virus infection in chronic infection with HBeAg-positive adult patients (immunotolerant patients): a systematic review

Tovo, Cristiane V.; Ahlert, Marcelo; Panke, Carine; de Mattos, Ângelo Z.; de Mattos, Angelo A.Author Information

Department of Internal Medicine, Post Graduation at Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rua Sarmento, Brazil

Received 29 April 2020 Accepted 20 July 2020

Correspondence to Cristiane Valle Tovo, MD, PhD, Department of Internal Medicine; Post-Graduation at Hepatology., Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA); Brazil, Tel: +55 51 3214 8158; e-mail: [email protected]
European Journal of Gastroenterology & Hepatology: May 2021 - Volume 33 - Issue 5 - p 605-609
doi: 10.1097/MEG.0000000000001907

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Abstract

Recently, a controversial approach suggesting the early treatment of chronic infection with hepatitis B “e” antigen-positive patients with hepatitis B virus (HBV) infection, has been proposed. The objective of this study is to systematically review medical literature regarding treatment of HBV infection in adult chronic infection with HBeAg-positive patients. A systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Original studies that evaluated the effect of antivirals in adult chronic infection with HBeAg-positive patients were included. The outcomes of interest were viral load suppression, the loss/seroconversion of HBeAg, the loss/seroconversion of hepatitis B surface antigen, and the development of cirrhosis or hepatocellular carcinoma. The search for eligible studies was performed in Excerpta Medica dataBASE, PubMed and Cochrane databases until January 2020, without language or date restriction. The risk of bias was evaluated using the Newcastle–Ottawa Scale for observational studies and the Revised Cochrane Risk-of-Bias Tool for randomized controlled trials. Two hundred ninety-six articles were retrieved. After analyzing titles and abstracts, 287 articles were excluded and nine were considered potentially eligible. From these, five were excluded after full-text analysis. Finally, four articles were included. Only two were randomized controlled trials. All studies were carried out in Asian patients. Results were variable with regard to viral load, negativation/seroconversion of HBeAg and HBsAg. One study demonstrated that treated patients developed cirrhosis or hepatocellular carcinoma less frequently than untreated individuals. Overall, the studies were of poor quality. In conclusion, the present systematic review demonstrated that, at present, there is not enough evidence to recommend treating this population of patients.
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

作者: StephenW 时间: 2021-4-7 09:59

成人HBeAg阳性（免疫耐受患者）慢性感染中乙型肝炎病毒感染的治疗：系统评价

Tovo，克里斯蒂安娜（Cristiane V.）；马赛洛（Ahlert），马塞洛（Marcelo）；潘克，卡琳； de Mattos，ngelo Z .; de Mattos，Angelo A.作者信息

巴西阿雷格里港波德阿雷格里联邦大学肝病学院内科，毕业后，巴西鲁门萨门托

2020年4月29日收到2020年7月20日接受

对应于内科医学博士Cristiane Valle Tovo；阿雷格里港波多黎各公民大学肝病学专业毕业（UFCSPA）；巴西，电话：+55 51 3214 8158；电子邮件：[email protected]
《欧洲胃肠病学和肝病学杂志》：2021年5月-第33卷-第5期-第605-609页
doi：10.1097 / MEG.0000000000001907

买

抽象的

最近，有人提出了一种有争议的方法，建议对乙型肝炎“ e”抗原阳性的乙型肝炎病毒（HBV）感染的慢性感染进行早期治疗。这项研究的目的是系统地复习有关成人HBeAg阳性慢性感染患者中HBV感染治疗的医学文献。根据系统评价和荟萃分析的首选报告项目的建议进行了系统评价。包括评价抗病毒药在成人HBeAg阳性慢性感染中作用的原始研究。感兴趣的结果是抑制病毒载量，HBeAg的丢失/血清转化，乙型肝炎表面抗原的丢失/血清转化以及肝硬化或肝细胞癌的发展。直到2020年1月，在Excerpta Medica数据库，PubMed和Cochrane数据库中进行符合条件的研究的搜索，没有语言或日期限制。使用纽卡斯尔-渥太华量表进行观察性研究，并使用经修订的Cochrane偏见风险工具进行随机对照试验，评估偏倚的风险。共检索到266篇文章。在分析标题和摘要后，排除了287篇文章，其中9篇被认为具有潜在资格。经过全文分析后，从这些文件中排除了五个。最后，包括四篇文章。只有两项是随机对照试验。所有研究均在亚洲患者中进行。结果在病毒载量，HBeAg和HBsAg的阴性/血清转换方面是可变的。一项研究表明，接受治疗的患者发生肝硬化或肝细胞癌的频率低于未经治疗的个体。总体而言，研究质量较差。总之，目前的系统评价表明，目前没有足够的证据推荐治疗该人群。
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