Combination Treatment Of Regimens Based On Peg-interferon Fou HBe Antigen Negative Chronic Hepatitis B Focusing On Hepatitis B Suiface Antigen Clearance Or Seroconversion:A Meta-analysis

Aims : Serological conversion or clearance of hepatitis b surface antigen(HBsAg)is considered to be an ideal endpoint for clinical treatment.The purpose of the present meta-analysis was to evaluate the effect of combined therapy with pegylated interferon(peg-IFN)and nucleotide analogues(NAs)on HBsAg loss or seroconversion in subjects with HBeAg-negative chronic hepatitis B(CHB).Methods : Pubmed,Medline and Embase databases were searched from January 1.2000 to May 1.2019.The Review Manager 5.3 software was used for meta-analysis of HBsAg clearance and conversion rates after treatment follow-up.Result:1.Among patients with CHB who were HBeAg(-)after 48 weeks therapy follow-up for 48 weeks-3 years,the rate of HBsAg clearance and seroconversion in combination group(5.7%)are higher than monotherapy group(3.5%),However,there is no statistical differences inHBsAg clearance(OR = 1.62,95% CI: 0.68,3.85,p = 0.28)between combination therapy and monotherapy;the rate of HBsAg seroconversion in combination group(5.3%)are higher than monotherapy group,there is statistical differences in HBsAg seroconversion(OR = 2.02,95% CI: 0.83,4.90,p = 0.12).2.According to the subgroup analysis of different monotherapy type(NAs and peg-IFN),in NAs therapy group,combination therapy HBsAg clearance rate was 5.4%,significantly higher than the single use of NAs therapy,and The difference was statistically significant(OR = 15.96,95%CI: 2.96,85.85,p = 0.001),in peg-IFN therapy group HBsAg clearance rate of combined treatment was 4.8%,HBsAg clearance rate of single peg-IFN therapy was 6.0%,there was no statistically difference(OR = 0.72,95%CI:0.37,1.41,p = 0.34),HBsAg clearance statistically different between the two subgroups(p < 0.05).Conclusion:1.Peg-IFN based-on combination therapy is superior to NAs monotherapy in terms of HBsAg clearance and conversion rate for HBeAg-negative patients with chronic hepatitis B.2.Peg-IFN combined with NAs therapy was not superior to peg-IFN alone in HBsAg clearance rate in HBeAg-negative patients with chronic hepatitis B.