| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000416114 |
| ISSN: | 1665-2681 |
| Authors: | Yu Shi1 Jianqin He1 Wei Wu1 Jianrong Huang1 Yida Yang1 Jifang Sheng1 Liang Yu1 Zhi Chen1 Hongyu Jia1 |
| Institutions: | 1Zhejiang University, School of Medicine, Hangzhou, Zhejiang. China |
| Year: | 2013 |
| Volumen: | 12 |
| Number: | 3 |
| Pages: | 364-372 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico |
| English abstract | The application of nucleos(t)ide analogues in hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) has not yet been widely accepted. Therefore, we conducted a meta-analysis of prospective and retrospective studies to examine the efficacy and safety of nucleos(t)ide analogues in treating HBV-related ACLF. Material and methods. Two independent reviewers identified eligible studies through electronic, and manual searches, and contact with experts. Three-month mortality was defined as the primary efficacy measure. ACLF reactivation and HBV DNA inhibition were secondary efficacy measures. Quantitative meta-analyses were performed to compare differences between nucleos(t)ide analogue and control groups. Results. Five eligible studies were identified. Antiviral treatment with nucleos(t)ide analogues led to significant reduction of HBV DNA [HBV DNA reduction > 2 log: 70.4 vs. 29%, RR = 2.29, 95%CI (1.49, 3.53), P < 0.01]. ACLF patients receiving nucleos(t)ide analogue had significantly lower 3-month mortality [44.8 vs. 73.3%, RR = 0.68, 95%CI (0.54, 0.84), P < 0.01] as well as incidence of reactivation [1.80 vs. 18.4%, RR = 0.11, 95%CI (0.03, 0.43), P < 0.01] compared to those who did not. There was no significant difference in the prognosis of patients treated with entecavir or lamivudine [36.4 vs. 40.5%, RR = 0.77, 95%CI (0.45, 1.32), P = 0.35]. No drug-related adverse events were reported during follow-up. Conclusion. Our findings suggest that nucleos(t)ide analogue treatment reduces short-term mortality as well as reactivation of HBV-related ACLF patients. Nucleos(t)ide analogues are well-tolerated during therapy, and suggestive evidence indicates that entecavir and lamivudine confer comparable short-term benefits in these patients. However, further studies are needed to clarify these observations |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Microbiología, Farmacología, Virus de la hepatitis B, Insuficiencia hepática aguda, Enfermedad hepática crónica, Meta-análisis, Análogos de nucleósidos, Análogos de nucleótidos |
| Keyword: | Gastroenterology, Microbiology, Pharmacology, Hepatitis C virus, Acute liver failure, Chronic liver disease, Meta-analysis, Nucleoside analogues, Nucleotide analogues |
| Full text: | Texto completo (Ver PDF) |
