title: Meta-analysis of prophylactic entecavir or lamivudine against hepatitis B virus reactivation.
abstract: Introduction and aim. Studies suggest that entecavir and lamivudine are useful as prophylactics against hepatitis B virus (HBV) reactivation in patients undergoing chemotherapy or immunosuppressive therapy, but which drug is more effective is unclear. Here we meta-analyzed available evidence on relative efficacy of prophylactic entecavir or lamivudine therapy in patients with chronic or resolved hepatitis B infection who were undergoing chemotherapy or immunosuppressive therapy.
  
  
  METHODS
  Two reviewers searched PubMed, EMBASE and Google Scholar as well as reference lists in relevant articles to find studies published between January 2005 and May 2015 that met inclusion and exclusion criteria. Data on HBV reactivation, HBV-related hepatitis and all-cause mortality were extracted from the studies and meta-analyzed.
  
  
  RESULTS
  A total of eight studies involving 593 patients were included in the meta-analysis, which was performed using a fixed-effect model since no significant heterogeneity was found. Entecavir was associated with significantly lower risk of HBV reactivation than lamivudine (RR 0.29, 95% CI 0.17 to 0.52) as well as lower risk of HBV-related hepatitis (RR 0.11, 95% CI 0.03 to 0.40). The two drugs were associated with similar risk of all-cause mortality (RR 1.12, 95% CI 0.54 to 2.35). Egger's test suggested no significant publication bias in the meta-analysis.
  
  
  CONCLUSIONS
  The available evidence suggests that entecavir is more effective than lamivudine for preventing HBV reactivation and HBVrelated hepatitis in patients with chronic or resolved HBV infection who are undergoing chemotherapy or immunosuppressive therapy.
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qin
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Toronto General Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Zhou
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D019259:Lamivudine / Q000627:therapeutic use*; D014775:Virus Activation
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D019259:Lamivudine; C413685:entecavir; D006147:Guanine