Systematic review with network meta-analysis: sustained hepatitis B surface antigen clearance after pegylated interferon cessation.

Autor:	Zhang Y; Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital.; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital., Lin X; Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital.; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital., Wu H; Department of Medical Administration, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China., Chen J; Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital.; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital., Zheng Q; Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital.; Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital.
Jazyk:	angličtina
Zdroj:	European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Oct 01; Vol. 36 (10), pp. 1159-1170. Date of Electronic Publication: 2024 Jul 22.
DOI:	10.1097/MEG.0000000000002823
Abstrakt:	The efficacy of different pegylated interferon (PEG-IFN) treatment strategies for achieving sustained hepatitis B surface antigen (HBsAg) clearance in chronic hepatitis B (CHB) remains controversial. This study assesses the efficacy of different PEG-IFN treatment regimens and factors influencing sustained HBsAg clearance after PEG-IFN discontinuation. PubMed , Embase , Web of Science , and the Cochrane Library databases were searched from inception to June 2023, regarding PEG-IFN therapy in CHB. Methodological quality was assessed using the Cochrane risk of bias tool. We explored sources of heterogeneity through univariate meta-regression. Frequentist network meta-analyses were used to compare the efficacy of different PEG-IFN treatment strategies. We analyzed 53 studies (including 9338 CHB patients). After PEG-IFN withdrawal, the annual rates of HBsAg clearance and seroconversion were 6.9% [95% confidence interval (CI), 5.10-9.31] and 4.7% (95% CI, 2.94-7.42). The pooled 1-, 3-, and 5-year sustained HBsAg clearance rates were 7.4%, 9.9%, and 13.0%, and the sustained HBsAg seroconversion rates were 6.6%, 4.7%, and 7.8%, respectively. HBsAg quantification, hepatitis B e antigen status, and PEG-IFN treatment protocols were major sources of heterogeneity. Baseline HBsAg quantification was significantly lower in patients with sustained HBsAg clearance versus those without ( P  < 0.046). PEG-IFN combined with tenofovir has the highest probability of achieving HBsAg seroconversion (surface under the cumulative ranking of 81.9%). Sustained HBsAg clearance increased approximately linearly from years 1 to 5 after PEG-IFN discontinuation. Low baseline HBsAg quantification has a significant impact on sustained HBsAg clearance. PEG-IFN combined with tenofovir may be optimal in achieving sustained HBsAg seroconversion. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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