The efficacy of thymosin in the treatment of chronic hepatitis B virus infection: a meta-analysis.
BACKGROUND
Trials of thymosin treatment in chronic hepatitis B virus infection have been small and the results have been inconsistent.


OBJECTIVE
To conduct a meta-analysis to evaluate the efficacy of thymosin treatment in chronic hepatitis B virus infection.


METHODS
Randomized controlled trials comparing thymosin for over 24 weeks vs. placebo (or usual care) in the treatment of chronic hepatitis B virus infection were identified through MEDLINE, EMBASE and the Cochrane Register of Clinical Trials. Biochemical (normalization of transaminases) and virological (loss of hepatitis B virus DNA and hepatitis B e antigen) responses were analysed using the intention-to-treat method. The odds ratio was used to measure the magnitude of the efficacy.


RESULTS
Five trials (353 patients) were identified. The odds ratio (95% confidence interval) of the virological response of thymosin over placebo at the end of treatment, 6 months post-treatment and 12 months post-treatment were 0.56 (0.2-1.52), 1.67 (0.83-3.37) and 2.67 (1.25-5.68), respectively. There was an increasing trend of the virological response with time since the cessation of thymosin treatment (P=0.02). There was no difference in the biochemical response between the thymosin and placebo groups at the end of treatment, 6 months post-treatment and 12 months post-treatment.


CONCLUSIONS
Thymosin is effective in suppressing viral replication in chronic hepatitis B virus infection, but the effect is delayed until 12 months after the cessation of treatment.
Chan
H L
HL
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Tang
J L
JL
Tam
W
W
Sung
J J
JJ
D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D016239:MEDLINE; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D013947:Thymosin / Q000276:immunology / Q000627:therapeutic use*; D000637:Transaminases / Q000032:analysis; D016896:Treatment Outcome
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D013947:Thymosin; D000637:Transaminases