Efficacy of lamivudine combined with adefovir dipivoxil versus entecavir monotherapy in patients with hepatitis B-associated decompensated cirrhosis: A meta-analysis

Peng, Hong; Liu, Junying; Yang, Min Jae; Tong, Shiwen; Yin, Wenwei; Tang, Hui; Hu, Peng; Hu, Huaidong; Ren, Hong

doi:10.1002/jcph.181

Cited by 7 publications

(5 citation statements)

References 37 publications

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“…The nucleotide analog adefovir dipivoxil has a clear-cut effect in treating acute and chronic hepatitis B hepatocirrhosis and has shown many advantages, such as clinical strengths of low drug resistance and light side effects ( 1 , 2 ). Apart from interfering with the DNA transcription directly, adefovir dipivoxil can adjust the immune function of the body, including cellular and humoral immunity ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of adefovir dipivoxil on T cell immune function in the treatment of chronic hepatitis B and hepatocirrhosis

Lan

Huang

2016

Experimental and Therapeutic Medicine

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The aim of the present study was to investigate the T cell immune function in chronic hepatitis B hepatocirrhosis patients at the compensated and decompensated stage following treatment with adefovir dipivoxil. A total of 104 patients diagnosed with hepatitis B hepatocirrhosis during the period from October 2013 to October 2014 were enrolled in the study. Among the cases, there were 56 cases at compensated stage, and another 48 at decompensated stage. Adefovir dipivoxil was administered for antiviral therapy (10 mg/time, 1 time/day, for a total of 24 weeks), and we compared the virus disappearance rate, liver function improvement and T cell immune function between the two groups before and after treatment. The difference between the virus disappearance rate in the two groups was not statistically significant (P>0.05). The decreased level of ALT decrease in the compensated group was significantly higher than that in the decompensated group, while the increased level of albumin in the compensated group was significantly higher as well. The differences showed statistical significance (P<0.05). After treatment, the level of CD4+ and CD4+/CD8+ ratio were higher than before treatment, while the level of CD8+ was lower after treatment than before treatment in the two groups. The differences all showed statistical significance (P<0.05). The CD4+CXCR5+ T follicular helper (TFH) cell level in the two groups was higher after treatment, as was interleukin-2 and interferon-γ. The differences all showed statistical significance (P<0.05). As for comparison between groups, the difference had no statistical significance (P>0.05). Adefovir dipivoxil treatment can improve T cell immune function at the compensated and decompensated stages in chronic hepatitis B hepatocirrhosis patients. This may be associated with virus disappearance and liver function improvement.

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Section: Introductionmentioning

confidence: 99%

Effect of adefovir dipivoxil on T cell immune function in the treatment of chronic hepatitis B and hepatocirrhosis

Lan

Huang

2016

Experimental and Therapeutic Medicine

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“…There were also some studies exploring the efficacy of LAM combined with ADV versus ETV monotherapy in patients with hepatitis B associated decompensated cirrhosis. The reduction of ALT levels, HBV DNA levels, the rate of ALT normalization, undetectable HBV DNA, HBV e antigen (HBeAg) loss, HBeAg seroconversion and mortality were similar between the two groups ( Lian et al., 2013 ; Peng et al., 2014 ). Our data showed that both of the virological response rate and ALT normalization rate were higher after 12-month therapy in ETV monotherapy group compared with combination group.…”

Section: Discussionmentioning

confidence: 94%

Ascites re-compensation in HBV-related first decompensated cirrhosis after anti-viral therapy

Zong

Xiong

et al. 2023

Front. Cell. Infect. Microbiol.

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Effective antiviral therapy can significantly improve the long-term prognosis of HBV-related decompensated patients, and re-compensation may be achieved in part of the patients. To explore the re-compensation of ascites after HBV suppression and the risk factors, the clinical outcomes of 196 consecutive patients with HBV-related first decompensated cirrhosis of ascites treated with nucleos(t)ide analogue (NUC) were analyzed retrospectively. Among these patients, the median serum HBV DNA level was 5.0 (IQR, 3.0-6.0) log10 IU/mL before treatment. Most patients were given NUC with high barrier to resistance including ETV (152), TDF (1) and TAF (1). Initial combination of LAM plus ADV and LdT plus ADV was used in 41 patients and 1 patients, respectively. After NUC treatment, the percentage of patients with ascites regression was 77.6%, 81.4%, 70.5%, 93.8%, 80.8% at 12, 24, 36, 48, 60 months, respectively (P<0.001). The distribution of ascites severity showed that the patients’ ascites improved, with the proportion of no ascites and mild ascites gradually increased. The proportion of re-compensation of ascites defined as negative HBV DNA, improved liver function and ascites regression (off diuretics) was 59.7%, 70.0%, 52.3%, 59.4%, 46.2% at 12, 24, 36, 48, 60 months (P<0.001). The rate of ascites regression was higher in viral response (VR) cohort when compared with that in non-VR cohort. Univariate and multivariable analysis showed that level of serum ALT (OR:0.988, 95%CI, p=0.029) and load of serum HBV DNA (OR:0.78895%CI, p=0.044) at baseline were risk factors of re-compensation of ascites. This study demonstrated that antiviral therapy could reverse decompensation of ascites in HBV-related first decompensated cirrhosis and the level of ALT and HBV DNA were risk factors of ascites re-compensation.

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“…Por otro lado, a partir de distintas revisiones sistemáticas (35,36) , ETV ha demostrado buena respuesta antiviral en pacientes näive con niveles más avanzados de enfermedad (METAVIR F3-F4), aunque la mortalidad no se afecta significativamente. Aún no se han reportado resultados de efectividad con TDF en enfermedad hepática avanzada.…”

Section: Discussionunclassified

Costo-efectividad de dos terapias antivirales para hepatitis B crónica en el Perú: entecavir y tenofovir

Bolaños-Díaz¹,

Tejada

Sanabria

et al. 2017

Rev Peru Med Exp Salud Publica

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Objetivos. Comparar en términos de costo-efectividad a entecavir (ETV) y tenofovir (TDF) en el tratamiento del virus de la hepatitis B (HBV) en hospitales públicos del Perú. Materiales y métodos. Estructuramos un modelo de Markov, definimos la efectividad en años de vida ajustados a calidad (AVAC). Incluimos los costos directos del tratamiento en soles desde la perspectiva del Ministerio de Salud del Perú. Calculamos la relación entre costo y efectividad incrementales (ICER). Realizamos análisis de sensibilidad determinístico y probabilístico, considerando un rango de disponibilidad de pago (WTP) desde uno hasta tres veces el producto bruto interno (PBI) per-cápita, y el beneficio monetario neto (BMN) o ICER en el caso del análisis de tornado. Resultados. El tratamiento con TDF es más efectivo y menos costoso que ETV. El ETV tuvo un costo por AVAC de S/ 4482, y de S/ 1526 para TDF. El TDF mantiene un BMN progresivamente mayor conforme aumenta la WTP. La tasa de descuento fue la única variable con efecto significativo en la incertidumbre del modelo. Conclusiones. El tratamiento con TDF es más costo-efectivo que ETV en hospitales públicos del Perú. Palabras clave: Hepatitis B, antiretrovirales, Economía médica. (fuente: DeCS BIREME). COST-EFFECTIVENESS OF TWO ANTIVIRAL THERAPIES FOR CHRONIC HEPATITIS B IN PERU: ENTECAVIR AND TENOFOVIR ABSTRACTObjetives. To compare in terms of cost-effectiveness to entecavir (ETV) and tenofovir (TDF) in the treatment of hepatitis B virus (HBV) in public hospitals in Peru. Materials and methods. We structured a Markov model. We define effectiveness adjusted life years for quality (QALY). We include the direct costs of treatment in soles from the perspective of the Ministry of Health of Peru. We estimate the relationship between cost and effectiveness ratios (ICER). We performed sensitivity analyzes considering a range of willingness to pay (WTP) from one to three times the Gross Domestic Product (GDP) per capita, and a tornado analysis regarding Monetary Net Profit (BMN) or ICER. Results. Treatment with TDF is more effective and less expensive than ETV. The ETV had a cost per QALY of PEN 4482, and PEN 1526 TDF. The PTO maintains a progressively larger with increasing WTP BMN. The discount rate was the only variable with a significant effect on model uncertainty. Conclusion: Treatment with TDF is more cost-effective than ETV in public hospitals in Peru. INTRODUCCIÓNEl virus de la hepatitis B (HBV) pertenece a la familia Hepadnaviridae (ortohepadnavirus), y puede ocasionar tanto enfermedad aguda como crónica. Existen diez genotipos (A-J) que difieren en un 8%, y múltiples subgenotipos que difieren en un 4%(1,2) . La transmisión es por vía sanguínea, mediante relaciones sexuales, por procedimientos médicos con material o productos contaminados y, en menor medida, por vía transplacentaria (3) .El diagnóstico se realiza mediante la detección del antígeno superficial (HbsAg), en los casos de infección aguda se detectará además inmunoglobulina M (Ig M) contra el antígeno del núcleo (HbcA...

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Efficacy of lamivudine combined with adefovir dipivoxil versus entecavir monotherapy in patients with hepatitis B-associated decompensated cirrhosis: A meta-analysis

Cited by 7 publications

References 37 publications

Effect of adefovir dipivoxil on T cell immune function in the treatment of chronic hepatitis B and hepatocirrhosis

Effect of adefovir dipivoxil on T cell immune function in the treatment of chronic hepatitis B and hepatocirrhosis

Ascites re-compensation in HBV-related first decompensated cirrhosis after anti-viral therapy

Costo-efectividad de dos terapias antivirales para hepatitis B crónica en el Perú: entecavir y tenofovir

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