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Review
. 2012 Sep 6:9:186.
doi: 10.1186/1743-422X-9-186.

The influence of hepatitis B virus on antiviral treatment with interferon and ribavirin in Asian patients with hepatitis C virus/hepatitis B virus coinfection: a meta-analysis

Jun-Ying Liu  1 , Yun-Jian Sheng, Huai-Dong Hu, Qing Zhong, Jing Wang, Shi-Wen Tong, Zhi Zhou, Da-Zhi Zhang, Peng Hu, Hong Ren
Affiliations
Review

The influence of hepatitis B virus on antiviral treatment with interferon and ribavirin in Asian patients with hepatitis C virus/hepatitis B virus coinfection: a meta-analysis

Jun-Ying Liu et al. Virol J. .

Abstract

Background: Clinical and laboratory studies have indicated that coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) can suppress one another, eliciting a dominant disease phenotype. To assess whether HBV can influence the antiviral effect of treatment on HCV, we performed a meta-analysis to comparatively analyze the response to interferon plus ribavirin treatment in patients with HBV/HCV coinfection and HCV mono-infection.

Methods: Published studies in the English-language medical literature that involved cohorts of HBV/HCV coinfection and HCV mono-infection were obtained by searching Medline, Cochrane and Embase databases. Studies that compared the efficacy of treatment with interferon plus ribavirin in HBV/HCV coinfection and HCV mono-infection were assessed. End-of-treatment virological response (ETVR), sustained virological response (SVR), HCV relapse rate, and alanine aminotransferase (ALT) normalization rate were compared between HBV/HCV coinfection and HCV mono-infection patients.

Results: Five trials involving 705 patients were analyzed. At the end of follow-up serum ALT normalization rates in patients with HCV mono-infection were significantly higher than in patients with HBV/HCV coinfection (odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.40-0.80, P = 0.001). The ETVR and SVR achieved in HBV/HCV coinfection patients were comparable to those in HCV mono-infection patients (OR = 1.03, 95% CI: 0.37-2.82, P = 0.96 and OR = 0.87, 95% CI: 0.62-1.21, P = 0.38, respectively). The rate of relapse for HCV or HCV genotype 1 was not significantly different between HBV/HCV coinfection patients and HCV mono-infection patients (OR = 1.55, 95% CI: 0.98-2.47, P = 0.06; HCV genotype 1: OR = 2.4, 95% CI: 1.17-4.91, P = 0.19).

Conclusions: Treatment with interferon and ribavirin achieves similar ETVR and SVR in HBV/HCV coinfection and HCV mono-infection. HBV/HCV coinfection patients had distinctively lower end of follow-up serum ALT normalization.

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Figures

Figure 1
Figure 1
Flow diagram of the meta-analysis study selection process.
Figure 2
Figure 2
Comparison of the ALT normalization rates achieved at the end of follow up in HBV/HCV coinfection and HCV mono-infection patients.
Figure 3
Figure 3
Comparison of the ALT normalization rates achieved at the end of treatment in HBV/HCV coinfection and HCV mono-infection patients.
Figure 4
Figure 4
Comparison of the HBVDNA resurgence HCV SVR groups and HCV non-SVR groups in HBV/HCV coninfection patients.
See this image and copyright information in PMC

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