A meta-analysis of nucleos(t)ide analogues in patients with decompensated cirrhosis due to hepatitis B.
BACKGROUND
The effect of nucleos(t)ide analogues therapy in patients with decompensated cirrhosis remains unclear.


OBJECTIVE
The purpose of this study was to evaluate the effect of nucleos(t)ide analogues on decompensated cirrhotic patients.


METHODS
An online search within PubMed, Web of Science, Embase, Cochrane Central of Register of Controlled Trials and China Biology Medicine disc from 1998-01-01 to 2011-09-05 was conducted. A meta-analysis was performed. Relative risks of mortality rate, Child-Pugh-Turcotte score and hepatitis B e-antigen (HBeAg) seroconversion of the decompensated patients were studied.


RESULTS
Eight studies involving 511 patients were included. Data showed that lamivudine and telbivudine significantly decreased the mortality rate (relative risk 0.36, 95 % confidence interval 0.25-0.54), improved the Child-Pugh-Turcotte scores (mean difference -3.23, 95 % confidence interval -3.98 to -2.48) and promoted HBeAg seroconversion (relative risk 7.48, 95 % confidence interval 2.31-24.20).


CONCLUSIONS
For patients with decompensated cirrhosis, lamivudine and telbivudine significantly decrease the mortality rate and disease severity. Also, they promote their HBeAg seroconversion.
Department of Gastroenterology , Zhongshan Hospital of Fudan University, Shanghai, 200032, People's Republic of China.
Yingnan
Y
Huang
Hao
H
Wu
Shengdi
S
Wu
Da
D
Fu
Yushui
Y
Ma
Xizhong
X
Shen
D000998:Antiviral Agents / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D009705:Nucleosides / Q000627:therapeutic use*; D009711:Nucleotides / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000998:Antiviral Agents; D009705:Nucleosides; D009711:Nucleotides; D018894:Reverse Transcriptase Inhibitors; D000077712:Telbivudine; D019259:Lamivudine; D013936:Thymidine