Evaluation of Peginterferon alfa-2a Response Rate in HBe-Negative Chronic Hepatitis B: A Systematic Review and Meta-Analysis
Evaluation of Peginterferon alfa-2a Response Rate in HBe-Negative Chronic Hepatitis B: A Systematic Review and Meta-Analysis
Jia Shi
ABSTRACT
Selecting the best medications for ALT and HBV-DNA control in HBeAg negative chronic hepatitis patients is necessary as they are vulnerable to developing cirrhosis and hepatocellular carcinoma. The present study was aimed to evaluate the response rate of treatment by Peginterferon alfa-2a. In this systematic review and meta-analysis, a review of articles evaluating response rate to Peginterferon alfa-2a was done through the databases of Scopus, Google Scholar, Pubmed (inception - 2019). Fourteen studies reporting the response rate of HBeAg negative chronic patients’ response to Peginterferon alfa-2a were included in the study. Cochran test was used to determine the homogeneity of the samples (based on Q test and I2 index). The prevalence was estimated based on the Random Effect size model in Revman software (version 3.5). The main result of this study showed that, in the 14 studies that PEG interferon was prescribed for patients with Hbe Ag negative chronic hepatitis B, the pooled incidence of treatment responders in comparison to non-responders was significantly lower (OR = 0.78, CI (0.7-0.87), p <0.0001). High heterogeneity was observed in this analysis (I2 = 95%, p <0.0001). to investigate factors affecting heterogeneity, a subgroup analysis was done based on the HBV genotype. 5 Studies in which most patients (>90%) had C genotype were compared with 3 studies with D genotype dominant study population. Again a high heterogeneity was observed in both genotype C and D dominant (I2=92% and 95%, respectively). However, higher pooled responders to non-responders rate were seen in C dominant populations versus D genotype (OR=0.72, CI (0.69-0.75), p<0.0001). Using Peginterferon alfa-2a alone is not the best choice of treatment due to the low rate of response to treatment; while considering the patient’s HBV genotype is important in response rate.
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