Effect of alpha-interferon treatment in children with hepatitis B e antigen-positive chronic hepatitis B-a Meta-analysis / 中华传染病杂志

ABSTRACT

Objective To conduct a Meta-analysis to evaluate the efficacy and safety of interfer on-α for treating HBeAg-positive chronic hepatitis B in children.Methods PubMed and Chinese Biomedical Database were searched from the beginning to April 2006,and the references of eligible studies were manually screened.Randomized controlled trials published in the English and Chinese literature comparing interferon-α with non-antiviral interventions(placebo or no treatment)in children with chronic hepatitis B were eligible for inclusion.Studies were included if patients were treated for at least 3 months and followed up for at least 6 months after cessation of therapy.Two investigators independently assessed the quality and extracted the data.The methodological quality of trails was assessed by the Jadad-scale plus allocation concealment.Heterogeneity was examined by Chi-square test.Fixed effects model or random effects model was used to pool the data.Sensitivity analyses were used in the treatment course.Results Seven randomized controlled studies with a total of 360 child chronic hepatitis B virus carriers who were positive for hepatitis B surface antigen and hepatitis B e antigen werc identified.It was found by Meta-analysis that,compared with the control,at the end of therapy,interferon-α could significantly clear HBeAg[22.1%vs 6.7%,OR 3.56,95% CI(1.74, 7.28),P=0.000 5],HBV DNA[33.7% vs 12.6%,OR 3.50,95% CI(2.03,6.06),P＜0.01], HBsAg [6.5% vs 0.5%,OR 7.10,95% CI(1.52,33.12),P=0.01],and achieve HBeAg seroconversion [17.3% vs 2.9%,OR 5.62,95% CI(1.65,19.18),P=0.006],but was not more effective in HBsAg seroversion[2.0% vs 0,OR 3.55,95%CI(0.35,35.93),P=0.28]and alanine aminotransferase(ALT)normalization[24.2% vs 16.2%,OR 1.72,95% CI(0.84,3.52), P=0.14].Conclusions Interferon a may be efficacious in clearance of HBeAg,HBV DNA and HhsAg, and achievement of HBeAg seroversion.Little evidence is available on HBsAg seroversion and ALT normali zation.Rigorously designed large sample size randomized double blind clinical trials with large sample size are required to further confirm and support the conclusion.