Pegylated interferon alfa for chronic hepatitis B: systematic review and meta‐analysis

Summary Conventional interferon alfa and nucleos(t)ide analogues, such as lamivudine, are frequently used for chronic hepatitis B ( CHB ) treatment, but are associated with adverse effects and viral resistance. Here we performed a systematic review and meta‐analysis evaluating all studies of pegylated interferon alfa ( PEG ‐ IFN α) treatment in hepatitis B e antigen ( HB eAg)‐positive and HB eAg‐negative patients with CHB . We searched electronic databases – PubMed, EMBASE , Cochrane Library and LILACS – for randomized controlled trials evaluating PEG ‐ IFN α therapy between 1999 and September 2014. Virological response was the primary outcome. We identified 14 studies involving 2829 patients. Our analysis revealed that PEG ‐ IFN α + lamivudine combination therapy produced better virological and biochemical responses than PEG ‐ IFN α monotherapy in HB eAg‐positive and HB eAg‐negative patients at the end of treatment. PEG ‐ IFN α + adefovir dipivoxil achieved better seroconversion rate than PEG ‐ IFN α in HB eAg‐positive patients at the end of treatment. The present findings demonstrated a beneficial response rate following PEG ‐ IFN α combination therapy with nucelos(t)ides among HB eAg‐positive and HB eAg‐negative patients with CHB . Further trials are needed to investigate simultaneous and sequential therapy strategies.