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A critical evaluation of the preventive effect of antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C or B: a novel approach by using meta-regression
- Source :
- Oncology. 82(5)
- Publication Year :
- 2012
-
Abstract
- Background: The extent of the effect of antiviral therapy and its predictors in preventing hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) or B (CHB) remain unclear. Methods: We conducted a systemic review and meta-analysis of published randomized controlled trials (RCTs) and cohort studies (CSs) up to December 2010. Preventive efficacy was measured as absolute reduction in 3- and 5-year cumulative incidence of HCC with antiviral therapy. Predictors for efficacy were identified by using meta-regression. Results: Twenty-two studies (5 RCTs; 17 CSs) were included for analysis. Antiviral therapy reduced 5-year cumulative incidence of HCC by 7.8% (95% CI 4.6–11.1; p < 0.0001) in patients with CHC and by 7.1% (95% CI 4.1–10.2; p < 0.0001) in patients with CHB. The efficacy was significant as early as 3 years after antiviral therapy. While adjusting for available study-level, patient and virological factors, RCT and higher sustained virological response were identified as pertinent predictors of superior preventive efficacy in patients with CHC, whereas lower hepatitis B virus e antigen seropositivity was identified in patients with CHB. Antiviral therapy did not result in differential preventive efficacy between cirrhotic and noncirrhotic patients with CHC or CHB. Conclusion: Antiviral therapy can reduce 3- and 5-year cumulative incidence of HCC in patients with CHC or CHB.
- Subjects :
- Oncology
Male
Cancer Research
medicine.medical_specialty
Carcinoma, Hepatocellular
Antiviral Agents
Cohort Studies
Hepatitis B, Chronic
Internal medicine
medicine
Carcinoma
Humans
Meta-regression
Randomized Controlled Trials as Topic
business.industry
Incidence (epidemiology)
Incidence
Liver Neoplasms
Antiviral therapy
General Medicine
Hepatitis C
Hepatitis B
Hepatitis C, Chronic
Middle Aged
medicine.disease
digestive system diseases
Hepatocellular carcinoma
Meta-analysis
Immunology
Female
business
Subjects
Details
- ISSN :
- 14230232
- Volume :
- 82
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Oncology
- Accession number :
- edsair.doi.dedup.....59e0c9690c988bd68afe1f4878124d49