| Objective： To evaluate the efficacy and safety of interferoncombination nucleoside analogues for treatingt chronic hepatitis B.Methods: Computer search for literature documented in PubMed,Embase,Cochrane, CNKI database, VIP database and Chinese biomedicalliterature database (CBM) from2005-01to2014-02.the English term asTelbivudine, Lamivudine, Adefovir, entecavir and Tenofovir, nucleotideanalogues, interferon, randomized controlled trials, chronic hepatitis B,Chinese keywords as interferon and Lamivudine and Adefovir ester,entecavir Tenofovir chronic hepatitis B and a randomized controlled trial.The quality of the literature of all included in the evaluation andinformation extraction by using the Jadad score was completed by twoindependent researchers. Using Cochrance registries RevMan5.0software for Meta analysis. Heterogeneity analysis using chi squaretest,odds ratio (OR) as the effect size.Results: Fourteen randomized controlled trials references wasincluded, sevev papers of them are interferon combination lamivudinetreatment chronic hepatitis B, six papers of them are interferon combination adefovir treatment of chronic hepatitis B, one paper of themare interferon combination entecavir for treatment chronic hepatitis B.The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg is higher in the interferon combination nucleoside analoguesgroup than nucleoside analogues monotherapy group, difference wasstatistically significant,[(OR=2.32,95%,CI (1.91,2.80)],[(OR=3.35,95%,CI (2.51,4.46)].The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg is higher in the interferon combination nucleoside analoguesgroup than interferon monotherapy group, difference was statisticallysignificant,[(OR=4.69,95%CI(3.36,6.54)],[(OR=1.38,95%CI (1.18,1.61)].The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg is higher in the interferon combination lamivudine group thanlamivudine monotherapy group, difference was statistically significant[(OR=1.83,95%CI (1.43,2.32)],[(OR=1.89,95%CI (1.52,2.34)], interferoncombination lamivudine group can significantly reduce the presence ofmutations in the YMDD motif of HBV polymerase, difference wasstatistically significant [(OR=0.13,95%CI (0.07,0.22)].The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg is higher in the interferon combination lamivudine group thaninterferon monotherapy group, difference was statisticallysignificant[(OR=3.55,95%CI(2.36,5.36)],[(OR=1.50,95%CI (1.12,2.01)]. The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg is higher in the interferon combination adefovir group thanadefovir monotherapy group, difference was statistically significant[(OR=3.23,95%CI (2.28,4.58)],[(OR=4.86,95%CI (3.57,6.61)].The results of different treatment time analysis shows that rates ofreduction of HBV-DNA viral load and sustained clearance of serumHBeAg and returning to normal of ALT concentrations is higher in theinterferon combination adefovir group than interferon monotherapy group,difference was statistically significant[(OR=4.36,95%CI(2.67,7.13)],[(OR=1.65,95%CI(1.24,2.19)],[(OR=2.93,95%CI(1.85,4.64)].Conclusion: Combination therapy with interferon and nucleosideanalogues is superior to monotherapy with interferon or nucleosideanalogues. Rates of sustained clearance of serum HBeAg and reduction ofviral load are higher in the interferon combination lamivudine group thanthe interferon or nucleoside analogues monotherapy group,interferoncombination lamivudine group can significantly reduce the presence ofmutations in the YMDD motif of HBV polymerase.But application ofinterferon can appear related adverse reactions. |
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