The efficacy of lamivudine in acute viral hepatitis with hepatitis B virus

Apostolescu, Cătălin; Rebedea, I.; Colţan, Gabriel; Iacob, S.; Căruntu, Florin Alexandru

doi:10.1016/s0168-8278(01)81400-8

Cited by 2 publications

(6 citation statements)

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“…Subgroup analysis excluding trials with high risk of bias (20,22) had no impact on the seroconversion of HBsAg when lamivudine was compared with standard-of-care (OR: 0.5, 95% CI 0.26 to 0.95, p = 0.03) (Fig. 5) or undetectable HBV DNA (OR:0.6, 95% CI 0.30 to 1.18, p = 0.14) (Fig.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Five trials, including 627 adult participants, were assessed in this review. Two of them conducted in Romania (20,24), one in Germany (23), one in China (22), and one in India (21). None of the trials included patients with fulminant acute liver failure.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The inclusion criterion for patients of these trials was severe acute hepatitis B de ned by biochemical and serologic parameters. One trial (20) did not de ne criteria for the severity of acute hepatitis B infection. See Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Assessment of outcome measures included seroconversion and undetected DNA (20)(21)(22), decrease in bilirubin levels, seroconversion and undetected DNA (23), seroconversion, and decrease in HBV viral load (24). Trials assessed and reported different outcome measures, depending on the technique used.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…The outcomes (serological cure and adverse events) were communicated in all reports, excepting two trials (20,22) that did not report side effects. Most trials recruited fewer patients that were initially planned due to a drop in the incidence of hepatitis B related to vaccination programs and under-detection of new asymptomatic cases.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

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Lamividune and Entecavir for acute Hepatitis B. A systematic review and meta-analysis

Henriquez-Camacho

Gomez

Risco-Risco

et al. 2023

Preprint

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Background. Hepatitis B infection is associated with chronic liver disease with high morbidity. Complications of acute infection include severe acute hepatitis or fulminant liver failure. The purpose of this review is to determine the efficacy of nucleoside analog (lamivudine versus entecavir) compared to placebo or no intervention for treating acute primary HBV infection. Methods. The PRISMA statement criteria were followed. Randomized controlled trials (RCTs) and quasi-randomized studies that evaluated the outcomes of Nucleoside Analog (NA) therapy (Lamivudine or Entecavir) in acute hepatitis B infection were included. The following outcomes were considered: virological cure (PCR negative), elimination of acute infection (seroconversion of HBsAg), mortality, and serious adverse events. Searching of databases (Pubmed, Embase) until may 2023 was performed. A meta-analysis for drug intervention was performed, following a fixed-effect model. Subgroup analysis of trials with high risk of bias compared to trials with low risk of bias was assessed using Chi2 test for subgroup differences. Heterogeneity was assessed calculating the Chi2 statistic for heterogeneity. Results. The initial search identified 4870 references Finally, five trials with 627 adult participants were included. None of the trials included patients with fulminant acute liver failure. The inclusion criterion for patients of these trials was severe acute hepatitis B defined by biochemical and serologic parameters. In 5 trials Lamivudine was compared with placebo or standard-of-care, and only one trial compared three arms: entecavir, lamivudine, and placebo. The certainty of the evidence was low for all outcomes. Virological cure does not favours any intervention: OR 0.96, 95% CI 0.54 to 1.7 (p=0.90), I2=58%. Seroconversion of HBsAg to negative favours placebo/standard-of-care compared to lamivudine: OR 0.54, 95% CI 0.33 to 0.9 (p=0.02), I2=31%. Subgroup analysis excluding trials with high risk of bias had no impact on the seroconversion of HBsAg. The only trial that compared entecavir and lamivudine in terms of seroconversion of HBsAg favored entecavir over lamivudine (OR:3.64, 95% CI 1.31-10.13; 90 participants) but entecavir was not favored compared to standard-of-care (OR:1.71, 95% CI 0.67-4.38). Adverse events were mild and none of the patients stopped therapy or discontinued normal daily activities. Conclusion. The results suggest that there is insufficient evidence that both NA obtain superior results in terms of efficacy compared with placebo/standard-of-care in patients with acute viral hepatitis. No benefit has been reported with NA based on low quality evidence.

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Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

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Lamividune and Entecavir for acute Hepatitis B. A systematic review and meta-analysis

Henriquez-Camacho

Gomez

Risco-Risco

et al. 2023

Preprint

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Pharmacological interventions for acute hepatitis B infection

Kalafateli

Buzzetti

Thorburn

et al. 2017

Cochrane Database of Systematic Reviews

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Low or very low quality evidence suggests that progression to chronic HBV infection was higher in people receiving lamivudine compared with placebo, no intervention, or entecavir. Low quality evidence suggests that interferon may increase the adverse events after treatment for acute HBV infection. Based on a very low quality evidence, there is currently no evidence of benefit of any intervention in acute HBV infection. There is significant uncertainty in the results and further RCTs are required.

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The efficacy of lamivudine in acute viral hepatitis with hepatitis B virus

Cited by 2 publications

References 0 publications

Lamividune and Entecavir for acute Hepatitis B. A systematic review and meta-analysis

Lamividune and Entecavir for acute Hepatitis B. A systematic review and meta-analysis

Pharmacological interventions for acute hepatitis B infection

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