Long-term effect of interferon treatment on the progression of chronic hepatitis B: Bayesian meta-analysis and meta-regression

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http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00801.x/abstract

Long-term effect of interferon treatment on the progression of chronic hepatitis

B: Bayesian meta-analysis and meta-regression

Hui Jin1, Ning Pan2, Yi Mou3, Bei Wang1, Pei Liu1,*Article first published

online: 19 APR 2011

DOI: 10.1111/j.1872-034X.2011.00801.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Early View (Online Version of Record published before inclusion in an issue)

ABSTRACT

Aim: 

The long-term effects of interferon treatment on the progression of chronic

hepatitis B (CHB) have been studied extensively, but its true clinical benefits

and the predictors of its efficacy remain unclear.

Methods: 

A systematic published work search was undertaken. Eligible studies included

those with interferon treatment and control groups, and with liver cirrhosis

(LC), hepatocellular carcinoma (HCC) or death as main outcomes. Bayesian

meta-analysis and meta-regression were performed to assess associations between

interferon treatment and disease progression, and the impacts of potential

covariates.

Results: 

Eleven articles met the inclusion criteria. LC, HCC and death were end-points in

four, nine and six studies, respectively. In all studies, interferon was

associated with significant preventive effects on HCC according to the

DerSimonian–Laird method (relative risk [RR] = 0.470, 95% confidence interval

[CI] = 0.260–0.850) and Bayesian method adjusting underlying risk (RR = 0.249,

95% Bayesian credible intervals [bCI] = 0.049–0.961), but not according to

Bayesian meta-analysis (RR = 0.274, 95% BCI = 0.059–1.031); and it showed

similar effects in death but not in LC. However, most of the high-quality

studies never revealed protective benefits in these end-points. Bayesian

meta-regression identified Asian ethnicity in death, higher hepatitis B

e-antigen (HBeAg) seroconversion rate or positivity rate, and length of follow

up (≤5 years) in HCC as potentially protective against disease progression.

Subgroup analysis confirmed similar effects from these factors in HCC and death.

Conclusion:  Additional evidence is needed to support the role of interferon

in delaying CHB progression.