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

Hepato-gastroenterology Pub Date : 2015-01-01
Ya-li Zhang, Jie Zhang, Li-yan Cui
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引用次数: 0

摘要

背景/目的:酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸(YMDD)突变是拉米夫定治疗慢性乙型肝炎(CHB)的主要限制因素。本研究的目的是通过荟萃分析来评估LAM联合IFN-α是否比拉米夫定单药治疗CHB中YMDD突变的发生更有优势。方法:检索电子数据库,计算优势比(OR)及其95%置信区间(CI),并汇总结果。结果:我们的荟萃分析显示,IFN-α2b、IFN-α2a和Peg-IFN-α2a分别联合LAM和LAM单药治疗的YMDD突变率差异(95% CI, 3.25 ~ 9.70, 95% CI, 5.77 ~ 17.51, 95% CI, 6.79 ~ 26.13)。与联合用药组和序贯联合用药组相比,LAM单药组YMDD突变率升高(95% CI分别为6.79 ~ 22.16和2.69 ~ 7.75)。在HBeAg阳性患者中,联合治疗的YMDD突变率低于LAM单药治疗(95% CI, 4.98 ~ 13.23)。结论:我们目前的荟萃分析表明,与LAM单药治疗相比,不同类型的IFN-a联合LAM可显著降低YMDD突变率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Hepato-gastroenterology
Hepato-gastroenterology 医学-外科
自引率
0.00%
发文量
1
审稿时长
1.9 months
期刊介绍: Hepato-Gastroenterology has been discontinued as of 2015. Extremely limited quantities of back issues in print available for sale.
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