Tenofovir Disoproxil Fumarate And Interferon Combination Therapy For Chronic Hepatitis B:A Meta-analysis

Objective: To investigate the efficacy of tenofovir disoproxil fumarate(TDF)plus interferon(IFN)in the treatment of chronic hepatitis B(CHB)compared to tenofovir disoproxil fumarate、interferon alone.Methods: We searched databases including PubMed,The Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),database for Chinese Technical Periodicals(VIP)and WanFang Digital Journal Full-text Database to collect studies about tenofovir disoproxil fumarate combined with interferon versus TDF or IFN monotherapy for CHB patients.A meta-analysis was performed using RevMan 5.3 software.Results: A total of 7 original randomized controlled trials(RCTs)involving 1260 patients met the inclusion criteria,of which 6 studies were related to TDF combined with IFN versus TDF monotherapy,and 2 studies were involved in TDF combined with IFN versus IFN monotherapy.Among these clinical studies,the trial groups were treated with interferon plus enofovir diso proxil fumarate while the observation control group were given tenofovir disoproxil fumarate or interferon alone.The results of meta-analysis indicated that: compared to TDF monotherapy,TDF combined with IFN was more effective in HBsAg negative conversion rate(RR=16.22,95% CI:1.94～135.43,P=0.01),HBeAg negative conversion rate(RR=1.85,95% CI:1.27～2.71,P0.001)and made no significant differences in HBV DNA negative rate(RR=0.86,95% CI:0.33～2.29,P=0.77),HBeAg serological conversion rate(RR=1.15,95% CI:0.17～7.91,P=0.89),recovery rates of ALT(RR=0.99,95% CI:0.70～1.40,P=0.96);compared to TDF monotherapy,TDF combined with IFN was superior to HBV DNA negative rate(RR=1.40,95% CI:1.09～1.81,P=0.009),HBsAg negative conversion rate(RR=1.75,95% CI:1.18～2.58,P=0.005),HBeAg serological conversion rate(RR=1.48,95% CI:1.05～2.08,P=0.02)and was no significant influence on HBeAg negative conversion rate(RR=1.30,95% CI:0.98～1.73,P=0.07),recovery rates of ALT(RR=1.20,95% CI:0.97～1.49,P=0.10).Conclusions: Tenofovir disoproxil fumarate combined with interferon is superior to TDF monotherapy in decreasing HBsAg negative conversion rate and HBeAg negative conversion rate,and precedes IFN monotherapy in decreasing HBV DNA negative rate,HBsAg negative conversion rate,HBeAg serological conversion rate.