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Treatment with lamivudine versus lamivudine and thymosin alpha-1 for e antigen-positive chronic hepatitis B patients: a meta-analysis.

Zhang YY, Chen EQ, Yang J, Duan YR, Tang H - Virol. J. (2009)

Bottom Line: Currently, there is no evidence on the combination of lamivudine and thymosin alpha-1 on chronic hepatitis B patients.The aim of this study was to compare the effect of lamivudine monotherapy with that of lamivudine and thymosin alpha-1 combination therapy for the treatment of hepatitis B e antigen (HBeAg)-positive hepatitis B patients.Among HBeAg-positive patients, thymosin alpha-1 and lamivudine combination therapy may be more effective than lamivudine monotherapy, providing superior rates of biochemical response, virological response, and HBeAg seroconversion.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, PR China. zyycd@126.com

ABSTRACT

Background: Currently, there is no evidence on the combination of lamivudine and thymosin alpha-1 on chronic hepatitis B patients. The aim of this study was to compare the effect of lamivudine monotherapy with that of lamivudine and thymosin alpha-1 combination therapy for the treatment of hepatitis B e antigen (HBeAg)-positive hepatitis B patients.

Results: We searched PUBMED (from 1966 onwards), EMBASE (from 1966), CBMdisk (Chinese Biomedical Database, from 1978), CNKI (National Knowledge Infrastructure, from 1980), the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Eight trials (583 patients in total) were identified. The lamivudine and thymosin alpha-1 combination treatment was significantly superior to lamivudine treatment in terms of ALT normalization rate (80.2% vs. 68.8%, P = 0.01), virological response rate (84.7% vs. 74.9%, P = 0.002), and HBeAg seroconversion rate (45.1% vs. 15.2%, P < 0.00001).

Conclusion: Among HBeAg-positive patients, thymosin alpha-1 and lamivudine combination therapy may be more effective than lamivudine monotherapy, providing superior rates of biochemical response, virological response, and HBeAg seroconversion.

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Analysis of the normalization rate of ALT at the end of the treatment between lamivudine and thymosin versus lamivudine groups.
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Figure 1: Analysis of the normalization rate of ALT at the end of the treatment between lamivudine and thymosin versus lamivudine groups.

Mentions: The biochemical parameters at the end of the treatment are shown in Figure 1. The results of the eight studies showed normalization rates for ALT in the combination therapy group as 80.2%, compared to 68.8% in the monotherapy group at the end of treatment. No statistical heterogeneity was detected (χ2 = 10.02, df = 7, P = 0.19, I2 = 30.2%), allowing the use of a fixed effect model for meta-analysis. The difference of biochemical response rates at the end of treatment significantly favored the combination of Tα1 and lamivudine over lamivudine alone (RR 1.16, 95% CI 1.04–1.30, Z = 2.56, P = 0.01) (Figure 1).


Treatment with lamivudine versus lamivudine and thymosin alpha-1 for e antigen-positive chronic hepatitis B patients: a meta-analysis.

Zhang YY, Chen EQ, Yang J, Duan YR, Tang H - Virol. J. (2009)

Analysis of the normalization rate of ALT at the end of the treatment between lamivudine and thymosin versus lamivudine groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2693103&req=5

Figure 1: Analysis of the normalization rate of ALT at the end of the treatment between lamivudine and thymosin versus lamivudine groups.
Mentions: The biochemical parameters at the end of the treatment are shown in Figure 1. The results of the eight studies showed normalization rates for ALT in the combination therapy group as 80.2%, compared to 68.8% in the monotherapy group at the end of treatment. No statistical heterogeneity was detected (χ2 = 10.02, df = 7, P = 0.19, I2 = 30.2%), allowing the use of a fixed effect model for meta-analysis. The difference of biochemical response rates at the end of treatment significantly favored the combination of Tα1 and lamivudine over lamivudine alone (RR 1.16, 95% CI 1.04–1.30, Z = 2.56, P = 0.01) (Figure 1).

Bottom Line: Currently, there is no evidence on the combination of lamivudine and thymosin alpha-1 on chronic hepatitis B patients.The aim of this study was to compare the effect of lamivudine monotherapy with that of lamivudine and thymosin alpha-1 combination therapy for the treatment of hepatitis B e antigen (HBeAg)-positive hepatitis B patients.Among HBeAg-positive patients, thymosin alpha-1 and lamivudine combination therapy may be more effective than lamivudine monotherapy, providing superior rates of biochemical response, virological response, and HBeAg seroconversion.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, PR China. zyycd@126.com

ABSTRACT

Background: Currently, there is no evidence on the combination of lamivudine and thymosin alpha-1 on chronic hepatitis B patients. The aim of this study was to compare the effect of lamivudine monotherapy with that of lamivudine and thymosin alpha-1 combination therapy for the treatment of hepatitis B e antigen (HBeAg)-positive hepatitis B patients.

Results: We searched PUBMED (from 1966 onwards), EMBASE (from 1966), CBMdisk (Chinese Biomedical Database, from 1978), CNKI (National Knowledge Infrastructure, from 1980), the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Eight trials (583 patients in total) were identified. The lamivudine and thymosin alpha-1 combination treatment was significantly superior to lamivudine treatment in terms of ALT normalization rate (80.2% vs. 68.8%, P = 0.01), virological response rate (84.7% vs. 74.9%, P = 0.002), and HBeAg seroconversion rate (45.1% vs. 15.2%, P < 0.00001).

Conclusion: Among HBeAg-positive patients, thymosin alpha-1 and lamivudine combination therapy may be more effective than lamivudine monotherapy, providing superior rates of biochemical response, virological response, and HBeAg seroconversion.

Show MeSH
Related in: MedlinePlus