臺大醫院-內科部;臺大醫院-國家級卓越臨床試驗與研究中心;臺大醫院-腫瘤醫學部;臺大醫院-醫學研究部;臺大醫學院-毒理學研究所;臺大醫學院-腫瘤醫學研究所;YING-CHUN SHENCHIUN HSUCheng C.-C.Hu F.-C.ANN-LII CHENG2014-02-142018-07-092014-02-142018-07-092012http://ntur.lib.ntu.edu.tw//handle/246246/258845Background: 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, Basel99 bytestext/htmlAntiviral therapyChronic hepatitis BChronic hepatitis CHepatocellular carcinoma[SDGs]SDG3alpha 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 Topic10.1159/000337293http://ntur.lib.ntu.edu.tw/bitstream/246246/258845/1/index.html