Meta-analysis About The Risk Of Hepatitis B Virus Reactivation In NHL Patients After Receiving Rituximab Plus Chemotherapy

Objective:Many articles discussed the efficacy and safety of Rituximab plus other chemotherapies in non-Hodgkin lymphoma (NHL). However, the casual relationship between Rituximab and hepatitis virus B reactivation (HBV-R) causes more and more attention from domestic and foreign medical professionals. The purpose of this article is to research the relationship between Rituximab and HBV-R through using Meta-analysis.Method:We searched the commonly used databases, including PubMed, EMBASE, CBM, CNKI and so on, both in English and Chinese, from 1st Jan 1997 and 30th June 2014, using search words "lymphoma", "Rituximab", "Hepatitis B", "reactivation", to find those published related articles. Meta-analysis was performed in fixed-effects model, Mantel-Haenszel method using Review Manager 5.1, then extract data after assessing quality of studies included in this Meta-analysis. Publication bias was examined through funnel plot, Begg’s test and Egger’s test. Because Review Manager 5.1 does not provide Begg’s test and Egger’s test, we wrote macro program to do Begg’s test and Egger’s test by using IML in SAS software.Result:Using Meta-analysis, eleven eligible articles were selected. The conclusion is:in non-Hodgkin lymphoma patients with HBV infection, the pooled effect of Rituximab-based therapy on HBV-R increased comparing to those receive chemotherapy only (Relative risk 2.22,95% Cl 1.52～3.25, P< 0.0001). The robustness of the results was demonstrated by sensitivity analysis. After using Trim and Filling method to handle publication bias, the reactivation difference was still statistically significant.