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

医学 肝细胞癌 血清转化 内科学 随机对照试验 乙型肝炎病毒 HBeAg 乙型肝炎 观察研究 乙型肝炎表面抗原 病毒 免疫学 病毒载量 肝硬化
作者
Cristiane Valle Tovo,Marcelo Ahlert,Carine Panke,Ângelo Zambam de Mattos,Ângelo Alves de Mattos
出处
期刊:European Journal of Gastroenterology & Hepatology [Lippincott Williams & Wilkins]
卷期号:33 (5): 605-609 被引量:1
标识
DOI:10.1097/meg.0000000000001907
摘要

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.
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