Nucleos(t)ide analogues for preventing HBV reactivation in immunosuppressed patients with hematological malignancies: a network meta-analysis.
We aimed to evaluate the efficacy of five oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of hepatitis B virus (HBV) reactivation and HBV-related complications in chronic hepatitis B virus (CHB) infected patients with hematological malignancies receiving chemotherapy or hematopoietic stem cell transplantation (HSCT) by network meta-analysis.



The search identified 28 articles involving 5 different prophylactic regimens covering 1478 participants.



Among five prophylactic regimes, tenofovir (predicted probability, 90%), was the most effective intervention followed by entecavir (88%) in preventing HBV reactivation. There was no significant difference between tenofovir and entecavir for preventing HBV reactivation. With regards to other outcomes, tenofovir and telbivudine was not included to evaluate due to lack of relevant studies. Entecavir was the most effective intervention in reducing the risk of HBV related hepatitis (100%), HBV related death (61%) and all other causes of hepatitis (98%).



Tenofovir and entecavir might be the most potent regimes in prevention of HBV reactivation for CHB infected patients with hematological malignancies undergoing chemotherapy or HSCT.
a Division of Hematology , Renji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , China.
Min-Yue
MY
Zhang
b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.|c School of the First Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China.
Gui-Qi
GQ
Zhu
b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.|c School of the First Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China.
Ji-Na
JN
Zheng
b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.|c School of the First Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China.
Zhang
Z
Cheng
d Department of Anesthesiology , Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg , Genk , Belgium.
Sven
S
Van Poucke
b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.|e Institute of Hepatology, Wenzhou Medical University , Wenzhou , China.
Ke-Qing
KQ
Shi
a Division of Hematology , Renji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , China.
Hong-Hui
HH
Huang
a Division of Hematology , Renji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , China.
Fang-Yuan
FY
Chen
b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.|e Institute of Hepatology, Wenzhou Medical University , Wenzhou , China.
Ming-Hua
MH
Zheng
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000276:immunology / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D019259:Lamivudine / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D016019:Survival Analysis; D000077712:Telbivudine; D000068698:Tenofovir / Q000627:therapeutic use*; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects*
D000998:Antiviral Agents; D063065:Organophosphonates; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; D000225:Adenine; D013936:Thymidine
Hepatitis B virus reactivation; chemotherapy; hematological malignancy; hematopoietic stem cell transplantation; network meta-analysis; nucleos(t)ide analogues prophylaxis