Interferon-α Combined with Lamivudine for Children with Hepatitis B: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Ni , FANG Xueqin , CHEN Qiming ,  CHEN Qingfeng

Institute of Infectious Diseases, First Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

CHEN Qingfeng, Email: cqf0025@163.com

Keywords：

Children; Hepatitis B; Lamivudine; Interferon-α (IFN-α); Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20130175

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To systematically review the effectiveness and safety interferon-α (IFN-α) combined with lamivudine vs. IFN-α alone in treating children with Hepatitis B.
Methods 　Such databases as The Cochrane Library, PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data were electronically searched for randomized controlled trials (RCTs) on IFN-α combined with lamivudine in treating children with hepatitis B. Two reviewers screened literature, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software.
Results 　8 RCTs were included, with comparable baseline. The results of meta-analysis showed that, compared to the IFN-α alone group, the combined therapy group had higher negative rates of serum HBV-DNA and HBeAg. There was no significant difference in the positive rate of anti-Hbe and the incidence of adverse reaction between the two groups.
Conclusion 　Current evidence shows that IFN-α combined with lamivudine was more effective than IFN-α alone in treating children’s hepatitis B.

Citation： JIANG Ni,FANG Xueqin,CHEN Qiming,CHEN Qingfeng. Interferon-α Combined with Lamivudine for Children with Hepatitis B: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(8): 1013-1017. doi: 10.7507/1672-2531.20130175 Copy

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2.	Hsieh CC, Tzonou A, Zavitsanos X, et al. Age at first establishment of chronic hepatitis B virus infection and hepatocellular carcinoma risk: a birth order study. Am J Epidemiol, 1992, 136(9): 1115-1121.
3.	Choe BH, Lee JY, Jang YC, et al. Long-term therapeutic efficacy of lamivudine compared with interferon-α in children with chronic hepatitis B: the younger the better. JPGN, 2007, 44(1): 92-98.
4.	Korba BE, Cote P, Hornbuckle W, et al. Enhanced antiviral benefit of combination therapy with lamivudine and alpha interferon against WHV replication in chronic carrier woodchucks. Antiviral Therapy, 2000, 5(2): 95-104.
5.	Higgins JPT, Altman DG (editors). Chapter 8: Assessing risk of bias in included studies. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
6.	钟旬华, 邓欣, 陈心春, 等. 比较α-干扰素不同联合治疗方案对儿童HBeAg阳性慢性乙型肝炎的疗效. 中华实验和临床病毒学杂志, 2007, 21(1): 62-63.
7.	黄遵仁. 拉米夫定联合干扰素治疗儿童慢性乙型肝炎疗效观察. 临床医学, 2007, 28(4): 102-103.
8.	何世娟, 陈杰. 拉米夫定联合干扰素治疗HBeAg阳性儿童慢性乙肝的研究. 中国现代医生, 2008, 46(14): 11-12.
9.	Dikici B, Ozgenc F, Kalayci GA, et al. Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study. Journal of Gastroenterology and Hepatology, 2004, 19(2): 127-133.
10.	SelimoĞlu MA, AydoĞdu S, Ünal F, et al. Alpha interferon and lamivudine combination therapy for chronic hepatitis B in children. Pediatrics International, 2002, 44(4): 404-408.
11.	Dikici B, Bosnak M, Bosnak V, et al. Comparison of treatments of chronic hepatitis B in children with lamivudine and a-interferon combination and a-interferon alone. Pediatrics International, 2002, 44(5): 517-521.
12.	Kansu A, Doganci T, Akman AS, et al. Comparison of two different regimens of combined interferon-alpha2a and lamivudine therapy in children with chronic hepatitis B infection. Antiviral Therapy, 2006, 11(2): 255-261.
13.	Tümay D. KRONİK B HEPATİTLİ ÇOCUKLARDA İNTERFERON-α VE LAMİVUDİN TEDAVİSİ. Gulhane Med J, 2003, 45(4): 316–320.
14.	European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of chronic hepatitis B. J Hepatol, 2009, 50 (23): 227-242.
15.	万谟彬, 翁心华. 干扰素治疗慢性乙型肝炎专家建议(2010年更新). 中华传染病杂志, 2010, 28(4): 193-200.
16.	徐京杭, 于岩岩, 斯崇文, 等. 拉米夫定治疗乙型肝炎病毒e抗原阳性慢性乙型肝炎的早期病毒动态变化研究. 中华医学杂志, 2009, 89(41): 2902-2905.
17.	Sokucu S, Gokçe S, Suoglu OD, et al. Comparison of interferon monotherapy with interferon-lamivudine combination treatment in children with chronic hepatitis B. Indian J Gastroenterol, 2006, 25(3): 136-139.
18.	李亚男, 方蜂. 儿童乙型病毒性肝炎的治疗进展. 国外医学: 儿科学分册, 2005, 32(4): 226-229.
19.	周煜, 金辉, 刘沛. 乙肝免疫球蛋白宫内注射阻断乙肝母婴传播的系统评价. 中国循证医学杂志, 2012, 12(7): 791-798.
20.	曾雪梅, 门娅玲, 李睿, 等. 乙肝免疫球蛋白阻断乙肝病毒宫内感染的系统评价, 中国循证医学杂志, 2007, 7(11): 782-788.

1. Fact sheets: hepatitis B. Geneva: World Health Organization, July 2012.
2. Hsieh CC, Tzonou A, Zavitsanos X, et al. Age at first establishment of chronic hepatitis B virus infection and hepatocellular carcinoma risk: a birth order study. Am J Epidemiol, 1992, 136(9): 1115-1121.
3. Choe BH, Lee JY, Jang YC, et al. Long-term therapeutic efficacy of lamivudine compared with interferon-α in children with chronic hepatitis B: the younger the better. JPGN, 2007, 44(1): 92-98.
4. Korba BE, Cote P, Hornbuckle W, et al. Enhanced antiviral benefit of combination therapy with lamivudine and alpha interferon against WHV replication in chronic carrier woodchucks. Antiviral Therapy, 2000, 5(2): 95-104.
5. Higgins JPT, Altman DG (editors). Chapter 8: Assessing risk of bias in included studies. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
6. 钟旬华, 邓欣, 陈心春, 等. 比较α-干扰素不同联合治疗方案对儿童HBeAg阳性慢性乙型肝炎的疗效. 中华实验和临床病毒学杂志, 2007, 21(1): 62-63.
7. 黄遵仁. 拉米夫定联合干扰素治疗儿童慢性乙型肝炎疗效观察. 临床医学, 2007, 28(4): 102-103.
8. 何世娟, 陈杰. 拉米夫定联合干扰素治疗HBeAg阳性儿童慢性乙肝的研究. 中国现代医生, 2008, 46(14): 11-12.
9. Dikici B, Ozgenc F, Kalayci GA, et al. Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study. Journal of Gastroenterology and Hepatology, 2004, 19(2): 127-133.
10. SelimoĞlu MA, AydoĞdu S, Ünal F, et al. Alpha interferon and lamivudine combination therapy for chronic hepatitis B in children. Pediatrics International, 2002, 44(4): 404-408.
11. Dikici B, Bosnak M, Bosnak V, et al. Comparison of treatments of chronic hepatitis B in children with lamivudine and a-interferon combination and a-interferon alone. Pediatrics International, 2002, 44(5): 517-521.
12. Kansu A, Doganci T, Akman AS, et al. Comparison of two different regimens of combined interferon-alpha2a and lamivudine therapy in children with chronic hepatitis B infection. Antiviral Therapy, 2006, 11(2): 255-261.
13. Tümay D. KRONİK B HEPATİTLİ ÇOCUKLARDA İNTERFERON-α VE LAMİVUDİN TEDAVİSİ. Gulhane Med J, 2003, 45(4): 316–320.
14. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of chronic hepatitis B. J Hepatol, 2009, 50 (23): 227-242.
15. 万谟彬, 翁心华. 干扰素治疗慢性乙型肝炎专家建议(2010年更新). 中华传染病杂志, 2010, 28(4): 193-200.
16. 徐京杭, 于岩岩, 斯崇文, 等. 拉米夫定治疗乙型肝炎病毒e抗原阳性慢性乙型肝炎的早期病毒动态变化研究. 中华医学杂志, 2009, 89(41): 2902-2905.
17. Sokucu S, Gokçe S, Suoglu OD, et al. Comparison of interferon monotherapy with interferon-lamivudine combination treatment in children with chronic hepatitis B. Indian J Gastroenterol, 2006, 25(3): 136-139.
18. 李亚男, 方蜂. 儿童乙型病毒性肝炎的治疗进展. 国外医学: 儿科学分册, 2005, 32(4): 226-229.
19. 周煜, 金辉, 刘沛. 乙肝免疫球蛋白宫内注射阻断乙肝母婴传播的系统评价. 中国循证医学杂志, 2012, 12(7): 791-798.
20. 曾雪梅, 门娅玲, 李睿, 等. 乙肝免疫球蛋白阻断乙肝病毒宫内感染的系统评价, 中国循证医学杂志, 2007, 7(11): 782-788.

Chinese Journal of Evidence-Based Medicine

Interferon-α Combined with Lamivudine for Children with Hepatitis B: A Meta-Analysis

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