A Critical Evaluation of the Preventive Effect of Antiviral Therapy on the Devel

StephenW

Oncology. 2012 Apr 27;82(5):275-289. [Epub ahead of print]
A Critical Evaluation of the Preventive Effect of Antiviral Therapy on the Development of Hepatocellular Carcinoma in Patients with Chronic Hepatitis C or B: A Novel Approach by Using Meta-Regression.Shen YC, Hsu C, Cheng CC, Hu FC, Cheng AL.
AbstractBackground: The extent of the effect of antiviral therapy and its predictors in preventing hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) or B (CHB) remain unclear. Methods: We conducted a systemic review and meta-analysis of published randomized controlled trials (RCTs) and cohort studies (CSs) up to December 2010. Preventive efficacy was measured as absolute reduction in 3- and 5-year cumulative incidence of HCC with antiviral therapy. Predictors for efficacy were identified by using meta-regression.
Results: Twenty-two studies (5 RCTs; 17 CSs) were included for analysis. Antiviral therapy reduced 5-year cumulative incidence of HCC by 7.8% (95% CI 4.6-11.1; p < 0.0001) in patients with CHC and by 7.1% (95% CI 4.1-10.2; p < 0.0001) in patients with CHB. The efficacy was significant as early as 3 years after antiviral therapy. While adjusting for available study-level, patient and virological factors, RCT and higher sustained virological response were identified as pertinent predictors of superior preventive efficacy in patients with CHC, whereas lower hepatitis B virus e antigen seropositivity was identified in patients with CHB. Antiviral therapy did not result in differential preventive efficacy between cirrhotic and noncirrhotic patients with CHC or CHB.

Conclusion: Antiviral therapy can reduce 3- and 5-year cumulative incidence of HCC in patients with CHC or CHB.

StephenW

肿瘤学杂志。 2012年四月27;82（5）:275-289。 [出处提前打印]
一个关键的抗病毒治疗对肝癌患者与慢性丙型肝炎或B发展的预防作用评价：使用meta回归的一个新途径。
沉远超，许，郑CC，胡锦涛FC，郑AL。
抽象

背景：抗病毒药物治疗和预防肝细胞癌（HCC）患者与慢性丙型肝炎（CHC）的或B（CHB）的发展，其预测的影响程度尚不清楚。方法：我们进行系统性回顾和荟萃分析发表的随机对照试验（RCTs）和队列研究（CSS）至2010年12月。绝对减少，在3  - 5年累积发病率与抗病毒治疗肝癌的预防效果。使用元回归预测疗效确定。结果：22个研究（5随机对照试验，17 CSS）被列入分析。抗病毒药物治疗肝癌的发病率5年累计减少7.8％（95％CI4.6-11.1，P <0.0001），与文委会和7.1％的患者（95％CI4.1-10.2，P <0.0001），慢性乙型肝炎患者。疗效是显著早抗病毒药物治疗后3年。 RCT和更高的持续病毒学应答的研究水平，病人和病毒学因素调整的同时，被确定为CHC患者的预防疗效优于有关预测，而较低的肝炎病毒e抗原血清学阳性CHB患者。抗病毒治疗没有导致在文委会或慢性乙型肝炎与肝硬化和非肝硬化患者之间的差别预防效果。结论：抗病毒治疗可以减少肝癌的3  - 5年累计与文委会或慢性乙型肝炎患者的发病率