The Effectiveness of Antiviral Treatments for Patients with HBeAg-Positive Chronic Hepatitis B: A Bayesian Network Analysis

Can J Gastroenterol Hepatol. 2018 Sep 12:2018:3576265. doi: 10.1155/2018/3576265. eCollection 2018.

Abstract

This network analysis is to determine the most effective treatment in HBeAg-positive patients. PubMed databases were searched for randomized controlled trials. Bayesian network meta-analysis was used to calculate the pairwise hazard ratios, 95% credible intervals, and ranking of surrogate outcomes. 9 studies were identified. The results show that NA add-on PEG IFN might be a better antiviral approach for HBeAg-positive patients in end point of treatment, with a comparable results of nucleoside/nucleotide analogs (NA), PEG IFN, PEG IFN add-on NA, PEG IFN combined NA, and PEG IFN combined placebo in alanine aminotransferase (ALT) normalization and HBV DNA undetectable. Cumulative probabilities of being the most efficacious treatment were NA add-on PEG IFN (30%) for HBeAg loss. The second efficacious (23%) is HBeAg seroconversion. This network analysis shows that NA add-on PEG IFN might be a better antiviral approach for HBeAg-positive patients in end point of treatment. But the long-term efficiency should be further determined.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Bayes Theorem
  • Drug Therapy, Combination
  • Hepatitis B e Antigens / blood*
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / immunology
  • Humans
  • Interferons / therapeutic use*
  • Network Meta-Analysis
  • Nucleosides / analogs & derivatives
  • Nucleotides
  • Polyethylene Glycols / therapeutic use
  • Randomized Controlled Trials as Topic

Substances

  • Antiviral Agents
  • Hepatitis B e Antigens
  • Nucleosides
  • Nucleotides
  • Polyethylene Glycols
  • Interferons