{"title":"干扰素-α联合拉米夫定与拉米夫定单药治疗慢性乙型肝炎感染中YMDD突变的出现:随机对照试验的荟萃分析","authors":"Ya-li Zhang, Jie Zhang, Li-yan Cui","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>Tyrosine-methionine-aspartate-aspartate (YMDD) mutations were the main limitation of lamivudine (LAM) for treating chronic hepatitis B (CHB). The aim of this study was to evaluate whether LAM combined with IFN-α offer advantage over lamivudine monotherapy for the occurrence of YMDD mutations in CHB using a meta-analysis.</p><p><strong>Methodology: </strong>We searched electronic databases and calculated the odds ratios (OR) with their 95% confidence intervals (CI) and pooled the results.</p><p><strong>Results: </strong>Our meta-analysis indicated that the difference of YMDD mutation rates between the combination therapy of IFN-α2b, IFN-α2a and Peg-IFN-α2a respectively plus LAM and LAM monotherapy (95% CI, 3.25-9.70, 95% CI, 5.77-17.51, 95% CI, 6.79-26.13, respectively). The rate of YMDD mutations in LAM monotherapy was increased when compared with combination and sequential combination group (95% CI, 6.79-22.16, and 95% CI, 2.69-7.75, respectively). The YMDD mutation rate in combination therapy was lower than that of LAM monotherapy in HBeAg positive patients (95% CI, 4.98-13.23).</p><p><strong>Conclusions: </strong>Our present meta-analysis suggests that different types of IFN-a in combination with LAM can significantly reduce the rate of YMDD mutation compared to LAM monotherapy.</p>","PeriodicalId":12985,"journal":{"name":"Hepato-gastroenterology","volume":"62 137","pages":"133-9"},"PeriodicalIF":0.0000,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interferon-α combined with lamivudine versus lamivudine monotherapy for the emergence of YMDD mutations in chronic hepatitis B infection: a meta-analysis of randomized controlled trials.\",\"authors\":\"Ya-li Zhang, Jie Zhang, Li-yan Cui\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>Tyrosine-methionine-aspartate-aspartate (YMDD) mutations were the main limitation of lamivudine (LAM) for treating chronic hepatitis B (CHB). The aim of this study was to evaluate whether LAM combined with IFN-α offer advantage over lamivudine monotherapy for the occurrence of YMDD mutations in CHB using a meta-analysis.</p><p><strong>Methodology: </strong>We searched electronic databases and calculated the odds ratios (OR) with their 95% confidence intervals (CI) and pooled the results.</p><p><strong>Results: </strong>Our meta-analysis indicated that the difference of YMDD mutation rates between the combination therapy of IFN-α2b, IFN-α2a and Peg-IFN-α2a respectively plus LAM and LAM monotherapy (95% CI, 3.25-9.70, 95% CI, 5.77-17.51, 95% CI, 6.79-26.13, respectively). The rate of YMDD mutations in LAM monotherapy was increased when compared with combination and sequential combination group (95% CI, 6.79-22.16, and 95% CI, 2.69-7.75, respectively). The YMDD mutation rate in combination therapy was lower than that of LAM monotherapy in HBeAg positive patients (95% CI, 4.98-13.23).</p><p><strong>Conclusions: </strong>Our present meta-analysis suggests that different types of IFN-a in combination with LAM can significantly reduce the rate of YMDD mutation compared to LAM monotherapy.</p>\",\"PeriodicalId\":12985,\"journal\":{\"name\":\"Hepato-gastroenterology\",\"volume\":\"62 137\",\"pages\":\"133-9\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hepato-gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepato-gastroenterology","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Interferon-α combined with lamivudine versus lamivudine monotherapy for the emergence of YMDD mutations in chronic hepatitis B infection: a meta-analysis of randomized controlled trials.
Background/aims: Tyrosine-methionine-aspartate-aspartate (YMDD) mutations were the main limitation of lamivudine (LAM) for treating chronic hepatitis B (CHB). The aim of this study was to evaluate whether LAM combined with IFN-α offer advantage over lamivudine monotherapy for the occurrence of YMDD mutations in CHB using a meta-analysis.
Methodology: We searched electronic databases and calculated the odds ratios (OR) with their 95% confidence intervals (CI) and pooled the results.
Results: Our meta-analysis indicated that the difference of YMDD mutation rates between the combination therapy of IFN-α2b, IFN-α2a and Peg-IFN-α2a respectively plus LAM and LAM monotherapy (95% CI, 3.25-9.70, 95% CI, 5.77-17.51, 95% CI, 6.79-26.13, respectively). The rate of YMDD mutations in LAM monotherapy was increased when compared with combination and sequential combination group (95% CI, 6.79-22.16, and 95% CI, 2.69-7.75, respectively). The YMDD mutation rate in combination therapy was lower than that of LAM monotherapy in HBeAg positive patients (95% CI, 4.98-13.23).
Conclusions: Our present meta-analysis suggests that different types of IFN-a in combination with LAM can significantly reduce the rate of YMDD mutation compared to LAM monotherapy.