Objective To compare lamivudine monotherapy versus lamivudine-thymosin alpha-1 combination therapy for HBeAg positive chronic hepatitis B.
Methods We searched CENTRAL (Issue 4, 2008), PubMed (up to December 2008), the Chinese Biomedical database (CBM, up to December 2008), and CNKI (up to December 2008). We also scanned references of all included studies and pertinent reviews. Quality assessment and data extraction were conducted by two reviewers independently. Meta-analyses were conducted using RevMan 5.0.
Results We identified 23 trials involving 1 488 patients. According to the results of meta-analyses, the HBeAg seroconversion rate of the combination therapy group was higher than that of the monotherapy group, both at the end of the treatment and the one year follow-up (RR=2.89, 95%CI 2.40 to 3.48; RR=4.99, 95%CI 2.99 to 8.31); and there were also significant differences between the two groups for secondary outcomes including HBV-DNA negative, ALT normalization, etc.. There was no significant difference between the two groups in adverse reaction.
Conclusion Lamivudine-thymosin alpha-1 combination therapy might be more effective than lamivudine monotherapy for HBeAg positive chronic hepatitis B. However, the results should be interpreted with caution because of the low quality of the included studies. High-quality, large scale randomized controlled trials are needed to further prove the results.
Citation： HU Haibo,XU Ting,CHENG Kai,SU Na,TANG Yao. Lamivudine Versus Lamivudine-Thymosin alpha-1 Combination Therapy for HBeAg Positive Chronic Hepatitis B: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(8): 904-909. doi: 10.7507/1672-2531.20090159 Copy