title: Effects of nucleoside analogue on patients with chronic hepatitis B-associated liver failure: meta-analysis.
abstract: OBJECTIVE
  The effectiveness of nucleoside analogue on patients with chronic hepatitis B-associated liver failure is still controversial. To address this issue, we did a review of the literatures and analyzed the data with emphasis on the survival and reduction in serum HBV DNA level.
  
  
  METHODS
  We searched 11 randomized controlled trials that included 654 patients with chronic hepatitis B-associated liver failure. 340 patients adopted nucleoside analogue, such as lamivudine (LAM), entecavir (ETV), telbivudine (LdT), or tenofovir disoproxil fumarate (TDF), and the remaining 314 patients adopted no nucleoside analogue or placebo. A meta-analysis was carried out to examine the survival, HBV e antigen serologic conversion, and reduction in serum HBV DNA level. The pooled odds ratio (OR) was used to reflect the treatment effects.
  
  
  RESULTS
  The overall analysis revealed nucleoside analogue significantly improved 1-month (OR = 2.10; 95% CI, [1.29, 3.41]; p = 0.003), 3-month (OR = 2.15; 95% CI, [1.26, 3.65]; p = 0.005), 12-month survival (OR = 4.62; 95% CI, [1.96, 10.89]; p = 0.0005). Comparison of 3-month HBV DNA showed significant reduction for adoptive nucleoside analogue patients (OR = 54.47; 95% CI, [16.37, 201.74]; p<0.00001). Comparison of 3-month HBV e antigen serologic conversion showed a highly significant improvement of HBV e antigen lost for patients received adoptive antiviral therapy (OR = 6.57; 95% CI, [1.64, 26.31]; p = 0.008).
  
  
  CONCLUSIONS
  The benefits of nucleoside analogue on patients with chronic hepatitis B-associated liver failure is significant for improving patient survival, HBV e antigen serologic conversion, and rapid reduction of HBV DNA levels.
authors: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors: Feng
authors: F
authors: Xie
authors: Long
authors: L
authors: Yan
authors: Jiongjiong
authors: J
authors: Lu
authors: Tao
authors: T
authors: Zheng
authors: Changying
authors: C
authors: Shi
authors: Jun
authors: J
authors: Ying
authors: Rongxi
authors: R
authors: Shen
authors: Jiamei
authors: J
authors: Yang
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology / Q000821:virology; D006801:Humans; D017114:Liver Failure, Acute / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens
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