https://scholars.lib.ntu.edu.tw/handle/123456789/161264
標題: | A Critical Evaluation of the Preventive Effect of Antiviral Therapy on the Development of Hepatocellular Carcinoma in Patients with Chronic Hepatitis C or B: A Novel Approach by Using Meta-Regression | 作者: | YING-CHUN SHEN CHIUN HSU Cheng C.-C. Hu F.-C. ANN-LII CHENG |
關鍵字: | Antiviral therapy;Chronic hepatitis B;Chronic hepatitis C;Hepatocellular carcinoma | 公開日期: | 2012 | 起(迄)頁: | 275-289 | 來源出版物: | Oncology | 摘要: | Background: The extent of the effect of antiviral therapy and its predictors in preventing hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) or B (CHB) remain unclear. Methods: We conducted a systemic review and meta-analysis of published randomized controlled trials (RCTs) and cohort studies (CSs) up to December 2010. Preventive efficacy was measured as absolute reduction in 3- and 5-year cumulative incidence of HCC with antiviral therapy. Predictors for efficacy were identified by using meta-regression. Results: Twenty-two studies (5 RCTs; 17 CSs) were included for analysis. Antiviral therapy reduced 5-year cumulative incidence of HCC by 7.8% (95% CI 4.6-11.1; p < 0.0001) in patients with CHC and by 7.1% (95% CI 4.1-10.2; p < 0.0001) in patients with CHB. The efficacy was significant as early as 3 years after antiviral therapy. While adjusting for available study-level, patient and virological factors, RCT and higher sustained virological response were identified as pertinent predictors of superior preventive efficacy in patients with CHC, whereas lower hepatitis B virus e antigen seropositivity was identified in patients with CHB. Antiviral therapy did not result in differential preventive efficacy between cirrhotic and noncirrhotic patients with CHC or CHB. Conclusion: Antiviral therapy can reduce 3- and 5-year cumulative incidence of HCC in patients with CHC or CHB. Copyright (C) 2012 S. Karger AG, Basel |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/258845 | DOI: | 10.1159/000337293 | SDG/關鍵字: | alpha interferon; alpha2a interferon; alpha2b interferon; beta interferon; hepatitis E antigen; interferon; lamivudine; placebo; recombinant alpha2b interferon; ribavirin; antiviral therapy; article; cancer incidence; cancer prevention; clinical research; disease association; drug efficacy; hepatitis B; hepatitis C; human; liver cell carcinoma; liver cirrhosis; meta analysis; priority journal; quantitative analysis; systematic review; treatment outcome; Antiviral Agents; Carcinoma, Hepatocellular; Cohort Studies; Female; Hepatitis B, Chronic; Hepatitis C, Chronic; Humans; Incidence; Liver Neoplasms; Male; Middle Aged; Randomized Controlled Trials as Topic |
顯示於: | 腫瘤醫學研究所 |
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