| Objective In order to estimate the relative efficacy of combination therapy of HBIG and LAM versus LAM monotherapy after liver transplantation.Methods:Databases including Medline(Ovid),PubMed,Embase,CENTRAL (Cochrane Central Register of Controlled Trails) and CBM,VIP,CNKI were searched until Dec 2008 and the clinical trials about combination therapy of hepatitis B immune globulins(HBIG) and lamivudine versure lamivudine monotherapy after liver transplantation were screened including randomised control test,non-randomised control test or case control study.The eligible clinical trials selection,the data extraction,and calculation of effective quantity were conducted independently by 2 investigators with Cochrane system evaluation method.A meta-analysis of the clinical trials was performed by using a fixed-effects model or random-effects model with Review Manage Software(V.5.0.18;Oxford,England).Results:11 clinical trials that contained 1421 patients(combination therapy group 1035 patients,LAM monotherapy group 386 patients) satisfied inclusive criteria and were non-randomised control test.Comparied with LAM monotherapy group,the risk of hepatitis B virus recurrence was significantly reduced by 73%,(RR=0.27,95%CI:0.20-0.37,p＜0.00001),the risk of YMDD mutation was significantly reduced by 72%(RR=0.28,95%CI: 0.15-0.53,p=0.00001),the risk of death associatied with HBV recurrence was significantly reducedby 79%(RR=0.21,95%CI:0.09-0.49,p=0.0003) in combination therapy(HBIG and LAM) group after liver transplantation;both survival ratio of recipients and grafts in combination therapy(HBIG and LAM) group were similar to LAM monotherapy group..Conclusion:current studies indicate that combination therapy of HBIG and LAM reduce the risk of hepatitis B virus recurrence,YMDD mutation and death associatied with HBV recurrence more than LAM monotherapy after liver transplantation. |
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