Meta-analysis: the effect of interferon on development of hepatocellular carcinoma in patients with chronic hepatitis B virus infection
- 650 Downloads
In patients chronically infected with hepatitis B virus, interferon has been used for the purpose of viral suppression by loss of hepatitis B e antigen (HBeAg) with or without seroconversion to antibody to HBeAg (anti-HBe). However, discussion about the effect of interferon on the development of hepatocellular carcinoma (HCC) has been controversial.
We conducted a meta-analysis of published studies. Eight studies were retrieved (1,303 patients), including two randomized controlled trials (RCTs) and six non-RCTs (553 patients received interferon treatment).
The pooled estimate of the preventive effect of treatment was significantly in favor of interferon (risk difference −5.0%; 95% CI −9.4 to −0.5, P = 0.028). By subgroup analyses, the preventive effect of interferon treatment was shown in the Asian population (risk difference −8.5%; 95%CI −13.6 to −3.6, P = 0.0012), the population with the incidental rate of HCC ≥10% if untreted with interferon (risk difference −9.4%; 95%CI −14.2 to −4.6, P = 0.0001), and the population with the proportion of HBeAg-positive patients to the study population ≥70% (RD −6.0%; 95%CI −11.8 to −0.2, P = 0.043). However, the preventive effect of interferon was not shown in the European population, the population with a lower incidental rate of HCC if untreated with interferon, and the population with the lower proportion of HBeAg-positive patients to the study population. An evaluation using the Begg method indicated no evidence of publication bias.
Interferon treatment is considered to restrain HCC development in patients with chronic hepatitis B virus infection, especially in HBeAg-positive Asians.
KeywordsHepatitis B e antigen Seroconversion Prognosis
- 1.World Health Organization. Hepatitis B 2000. http://www.who.int/mediacentre/factsheets/fs204/en/ Accessed 24 Nov 2007.
- 12.Tangkijvanich P, Thong-ngam D, Mahachai V, Kladchareon N, Suwangool P, Kullavanijaya P. Long-term effect of interferon therapy on incidence of cirrhosis and hepatocellular carcinoma in Thai patients with chronic hepatitis B. Southeast Asian J Trop Med Public Health. 2001;32:452–8.PubMedGoogle Scholar
- 30.Zhao H, Kurbanov F, Wan MB, Yin YK, Niu JQ, Hou JL, et al. Genotype B and younger patient age associated with better response to low-dose therapy: a trial with pegylated/nonpegylated interferon-alpha-2b for hepatitis B e antigen-positive patients with chronic hepatitis B in China. Clin Infect Dis. 2007;44:541–8.PubMedCrossRefGoogle Scholar