Min-Yue Zhang1, Gui-Qi Zhu2,3, Ji-Na Zheng2,3, Zhang Cheng2,3, Sven Van Poucke4, Ke-Qing Shi2,5, Hong-Hui Huang1, Fang-Yuan Chen1, Ming-Hua Zheng2,5. 1. a Division of Hematology , Renji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , China. 2. b Department of Hepatology , Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China. 3. c School of the First Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China. 4. d Department of Anesthesiology , Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg , Genk , Belgium. 5. e Institute of Hepatology, Wenzhou Medical University , Wenzhou , China.
Abstract
BACKGROUND: We aimed to evaluate the efficacy of five oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of hepatitis B virus (HBV) reactivation and HBV-related complications in chronic hepatitis B virus (CHB) infected patients with hematological malignancies receiving chemotherapy or hematopoietic stem cell transplantation (HSCT) by network meta-analysis. METHODS: The search identified 28 articles involving 5 different prophylactic regimens covering 1478 participants. RESULTS: Among five prophylactic regimes, tenofovir (predicted probability, 90%), was the most effective intervention followed by entecavir (88%) in preventing HBV reactivation. There was no significant difference between tenofovir and entecavir for preventing HBV reactivation. With regards to other outcomes, tenofovir and telbivudine was not included to evaluate due to lack of relevant studies. Entecavir was the most effective intervention in reducing the risk of HBV related hepatitis (100%), HBV related death (61%) and all other causes of hepatitis (98%). CONCLUSION: Tenofovir and entecavir might be the most potent regimes in prevention of HBV reactivation for CHB infected patients with hematological malignancies undergoing chemotherapy or HSCT.
BACKGROUND: We aimed to evaluate the efficacy of five oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of hepatitis B virus (HBV) reactivation and HBV-related complications in chronic hepatitis B virus (CHB) infectedpatients with hematological malignancies receiving chemotherapy or hematopoietic stem cell transplantation (HSCT) by network meta-analysis. METHODS: The search identified 28 articles involving 5 different prophylactic regimens covering 1478 participants. RESULTS: Among five prophylactic regimes, tenofovir (predicted probability, 90%), was the most effective intervention followed by entecavir (88%) in preventing HBV reactivation. There was no significant difference between tenofovir and entecavir for preventing HBV reactivation. With regards to other outcomes, tenofovir and telbivudine was not included to evaluate due to lack of relevant studies. Entecavir was the most effective intervention in reducing the risk of HBV related hepatitis (100%), HBV related death (61%) and all other causes of hepatitis (98%). CONCLUSION:Tenofovir and entecavir might be the most potent regimes in prevention of HBV reactivation for CHB infectedpatients with hematological malignancies undergoing chemotherapy or HSCT.