Meta-analysis: Treatment of hepatitis B infection reduces risk of hepato-cellular carcinoma.

August 6, 2008 at 9:10 am | Posted in hepatitis B | Leave a comment
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Meta-analysis: Treatment of hepatitis B infection reduces risk of hepato-cellular carcinoma.

Institute of Digestive Disease, the Chinese University of Hong Kong.

Background Chronic hepatitis B infection (CHB) leads to development of hepatocellular carcinoma (HCC) but the effects of treatment in preventing HCC is not clear. Aims We studied effects of interferon (IFN) or nucleoside/tide analog (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 (RR) of HCC with or without treatment were studied. Results 12 studies (n=2,742) enrolling patients treated by IFN versus 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 those without cirrhosis. Five studies (n=2,289) compared patients treated by NA versus 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 significant 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 reduce risk of HCC. While IFN benefited patients with cirrhosis, NA benefited patients with no cirrhosis and HBeAg positive CHB infection.

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