Meta-analysis:Long-term Nucleos(t)ide Analogues Therapy For Decompensated Cirrhosis Due To Hepatitis B

Objective: To assess the long-term efficiency and safety of nucleos(t)ide analoguestherapy for decompensated cirrhosis due to hepatitis B.Methods: According to the inclusion criterion of papers, the electronic databaseswere searched including Medline, PubMed, Embase, The Cochrane Library, CBM,CNKI, VIP, WANGFANG databases. Articles in related journals, conferenceproceedings and Academic Dissertations Proceedings, were manually searched andsome other articles were searched with Google. The search began on January,1997and lasted to December,2013. The quality of the documents was assessed by tworeviewers sperately, and checked crossly. Discussion or the third reviewer was invitiedwhen discrepancy happened. Meta-analysis was performed according to the data andits results were assessed by sensitive analysis and bias analysis. If meta-analysis can’tbe done, qualitative descriptions were made.Results: Nine documents involving802participants were included, There were429participants in treatment group and373participants in control group. Meta-analysisshowed:1. clinical outcomes have significant different in the mortality [relativerisk(RR)=0.32,95％confidence interval(CI)(0.23,0.42)], the incidence ofHepatocellular Carcinoma [RR=0.33,95％CI (0.19,0.58)], Child-Turcotte-Pugh(CTP)scores [MD=-3.10,95％CI (-4.53,-1.68)];2. liver biochemistry have significantdifferent in alanine aminotransferase [MD=-65.26U/L,95％CI (-104.33,-26.49)U/L], theserum total bilirubin [MD=-36.87μmol/L,95％CI (-51.94，-21.80) μmol/L], the serumalbumin [MD=8.16g/L,95％CI (5.99，10.33) g/L];3. virology have significant differentin HBV DNA undetectability [RR=5.57,95％CI (2.71，11.47)], HBeAg negativity[RR=3.54,95％CI (1.27，9.89)], HBeAg seroconversion [RR=6.74,95％CI (1.31，34.73)].Conclusion: Long-term treating decompensated cirrhosis due to hepatitis B applied bynucleos(t)ide analogue could decrease the mortality, the incidence of Hepatocellular Carcinoma, Child-Turcotte-Pugh（CTP） scores, and improve liver biochemistry suchas ALT, TBIL, ALB and virology such as HBV DNA undetectability, HBeAgnegativity, HBeAg seroconversion. Due to heterogeneity and potential publication bias,we should be cautious of the results.