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学科主题: 临床医学
题名:
Lamivudine or lamivudine combined with hepatitis B immunoglobulin in prophylaxis of hepatitis B recurrence after liver transplantation: a meta-analysis
作者: Rao, Wensheng; Wu, Xuejie2; Xiu, Dianrong1
关键词: hepatitis B immunoglobulin ; hepatitis B virus recurrence ; lamivudine ; liver transplantation ; YMDD mutant
刊名: TRANSPLANT INTERNATIONAL
发表日期: 2009-04-01
DOI: 10.1111/j.1432-2277.2008.00784.x
卷: 22, 期:4, 页:387-394
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Surgery ; Transplantation
研究领域[WOS]: Surgery ; Transplantation
关键词[WOS]: VIRUS RECURRENCE ; IMMUNE GLOBULIN ; PREVENTION ; INFECTION ; WITHDRAWAL ; RESISTANCE ; RECIPIENTS ; OUTCOMES ; ERA
英文摘要:

There is a controversy over whether the different outcomes of prophylaxis of hepatitis B virus (HBV) recurrence are attributable to different treatments. A systematic review and a meta-analysis were conducted to evaluate lamivudine monotherapy and combined therapy of lamivudine and hepatitis B immunoglobulin (HBIG) in HBV infected liver recipients. A fixed effects model was used for statistical pooling of relative risks (RR) for the different outcomes. Six articles (551 patients) fulfilled the inclusion criteria. Statistically significant differences were observed between lamivudine monotherapy and lamivudine + HBIG therapy in hepatitis B recurrence [P < 0.0001; RR = 0.38; 95% CI (0.25, 0.58)], YMDD mutant [P = 0.002; RR = 0.40; 95% CI (0.23, 0.72)] and hepatitis B recurrence in HBV-DNA positive patients before orthotopic liver transplantation [P < 0.00001; RR = 0.31; 95% CI (0.21, 0.45)]. No significant differences were observed in patient survival [P = 0.59; RR = 1.02; 95% CI (0.95, 1.09)], graft survival [P = 0.56; RR = 1.02; 95% CI (0.95, 1.09)] and diseases leading to death between the two groups [HBV recurrence leading to death: P = 0.05; RR = 0.47; 95% CI (0.22, 1.02); hepatocellular carcinoma recurrence leading to death: P = 0.13; RR = 0.34; 95% CI (0.09, 1.36)]. In conclusion, combination of lamivudine and HBIG can effectively decrease the recurrence rate of HBV and the incidence of YMDD mutant, but it can not improve patient survival and graft survival significantly. Well-designed large-sample trials are needed to evaluate the efficiency of combined therapy of lamivudine and HBIG in prophylaxis of HBV recurrence in liver graft recipients.

语种: 英语
WOS记录号: WOS:000263911400004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64641
Appears in Collections:北京大学第三临床医学院_普通外科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Gen Surg, Beijing 100083, Peoples R China
2.Peking Univ, Hosp 1, Beijing 100083, Peoples R China

Recommended Citation:
Rao, Wensheng,Wu, Xuejie,Xiu, Dianrong. Lamivudine or lamivudine combined with hepatitis B immunoglobulin in prophylaxis of hepatitis B recurrence after liver transplantation: a meta-analysis[J]. TRANSPLANT INTERNATIONAL,2009,22(4):387-394.
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