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Systematic review and meta-analysis: impact of anti-viral therapy on portal hypertensive complications in HBV patients with advanced chronic liver disease

Kong, Yuanyuan; Lv, Tingting; Li, Min; Zhao, Lianghui; Meng, Tongtong; Wu, Shanshan; Wei, Wei; ... Jia, Jidong; + view all (2022) Systematic review and meta-analysis: impact of anti-viral therapy on portal hypertensive complications in HBV patients with advanced chronic liver disease. Hepatology International , 16 pp. 1052-1063. 10.1007/s12072-022-10369-w. Green open access

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Abstract

Background: The efficacy of nucleos(t)ide analogs (NAs) in non-cirrhotic chronic hepatitis B (CHB) patients is well-established. However, their impact on complications of portal hypertension in advanced chronic liver disease (ACLD) is less well characterized. Methods: MEDLINE/PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and abstracts of major international hepatology meetings were searched for publications from Jan 1, 1995 to Nov 30, 2021. Randomized control trials and observational studies reporting the efficacy of NAs in ACLD patients were eligible. Pooled risk ratios (RRs) for outcomes of interest were calculated with a random-effect or fixed-effect model, as appropriate. Results: Thirty-nine studies including 14,212 ACLD patients were included. NA treatment was associated with reduced risks of overall hepatic decompensation events (RR, 0.51; 95% confidence interval [CI]: 0.37–0.71), such as variceal bleeding (RR, 0.44; 95% CI: 0.26–0.74) and ascites (RR, 0.10; 95% CI: 0.01–1.59), on a trend-wise level. Moreover, the risks of hepatocellular carcinoma (HCC) (RR, 0.48; 95% CI: 0.30–0.75) and liver transplantation/death (RR, 0.36; 95% CI: 0.25–0.53) were also reduced by NA treatment and the first-line NAs were superior to non-first-line NAs in improving these outcomes (RR, 0.85; 95% CI: 0.75–0.97 and RR, 0.85; 95% CI: 0.73–0.99, respectively). Conclusion: NA therapy lowers the risk of portal hypertension-related complications, including variceal bleeding, HCC, and liver transplantation/death.

Type: Article
Title: Systematic review and meta-analysis: impact of anti-viral therapy on portal hypertensive complications in HBV patients with advanced chronic liver disease
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s12072-022-10369-w
Publisher version: https://doi.org/10.1007/s12072-022-10369-w
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, Advanced chronic liver disease, Antiviral therapy, Meta-analysis, Systematic review, CHRONIC HEPATITIS-B, REDUCES HEPATOCELLULAR-CARCINOMA, VIRUS-RELATED CIRRHOSIS, DECOMPENSATED CIRRHOSIS, ENTECAVIR MONOTHERAPY, NUCLEOS(T)IDE ANALOGS, ADEFOVIR DIPIVOXIL, CLINICAL-OUTCOMES, LAMIVUDINE, EFFICACY
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10157265
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