Meta-analysis: treatment of hepatitis B infection reduces risk of hepatocellular carcinoma
Article first published online: 24 JUL 2008
© 2008 The Chinese University of Hong Kong. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 9, pages 1067–1077, November 2008
How to Cite
SUNG, J. J. Y., TSOI, K. K. F., WONG, V. W. S., LI, K. C. T. and CHAN, H. L. Y. (2008), Meta-analysis: treatment of hepatitis B infection reduces risk of hepatocellular carcinoma. Alimentary Pharmacology & Therapeutics, 28: 1067–1077. doi: 10.1111/j.1365-2036.2008.03816.x
- Issue published online: 7 OCT 2008
- Article first published online: 24 JUL 2008
- Publication data Submitted 30 May 2008 First decision 1 July 2008 Resubmitted 11 July 2008 Accepted 22 July 2008 Epub Accepted Article 24 July 2008
Background Chronic hepatitis B (CHB) infection leads to development of hepatocellular carcinoma (HCC), but the effects of treatment in preventing HCC are not clear.
Aim To study the effects of interferon (IFN) or nucleoside/tide analogue (NA) on the risk of developing HCC in CHB patients.
Methods Randomized trials, case–control and cohort studies were retrieved from five electronic databases and international conferences over the past 10 years. Relative risks (RRs) of HCC with or without treatment were studied.
Results Twelve studies (n = 2742) enrolling patients treated by IFN vs. control showed that the risk of HCC after treatment was reduced by 34% (RR: 0.66, 95% CI: 0.48–0.89). Benefit is more significant among patients with early cirrhosis than among those without cirrhosis. Five studies (n = 2289) compared patients treated by NA with control. The risk of HCC after treatment was reduced by 78% (RR: 0.22, 95% CI: 0.10–0.50). HBeAg-positive patients showed more significantly reduced HCC risk with treatment. Patients without cirrhosis benefited more from NA than those with cirrhosis. Resistance to NA has obviated the benefit of the treatment.
Conclusions IFN or NA treatment significantly reduces risk of HCC. While IFN benefited patients with cirrhosis, NA benefited patients with no cirrhosis and HBeAg-positive CHB infection.