Meta-analysis: reduction in hepatic events following interferon-alfa therapy of chronic hepatitis B.
BACKGROUND
The long-term benefit of interferon-alfa (IFN-α) treatment in preventing various hepatic complications is not certain.


OBJECTIVE
To study the effects of IFN-α on reducing the risk of developing overall hepatic events (hepatocellular carcinoma, cirrhotic complications and liver-related mortality) in chronic hepatitis B patients.


METHODS
Randomized controlled trials, case-control studies and cohort studies were retrieved from electronic databases and conference abstracts. Relative risks (RRs) of different hepatic complications among patients treated by IFN-α vs. no treatment or placebo were studied.


RESULTS
Eleven studies were identified totalling 975 patients treated by IFN-α vs. 1147 untreated controls for analysis. Patients were treated by IFN-α for 1-24 months with a post-treatment follow-up of 1-13 years. Treatment by IFN-α reduced the risk of overall hepatic events (RR 0.55, 95% confident interval or CI 0.43-0.70, P < 0.001) and cirrhotic complications (RR 0.46, 95% CI 0.32-0.67, P < 0.001) by 45% and 54% respectively. Patients who responded to IFN-α had more profound reduction in overall hepatic events (RR 0.20, 95% CI 0.05-0.87, P = 0.03) and cirrhotic complications (RR 0.19, 95% CI 0.09-0.38, P < 0.001) vs. the untreated controls.


CONCLUSIONS
Interferon-alfa treatment reduces the risk of hepatic events particularly among responders to treatment.
Wong
G L-H
GL
Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
Yiu
K K-L
KK
Wong
V W-S
VW
Tsoi
K K-F
KK
Chan
H L-Y
HL
D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D013223:Statistics as Topic; D016896:Treatment Outcome
D016898:Interferon-alpha