Efficacy Of Entecavir Antiviral Treatment In Chinese Patients With Hepatitis B Virus-Related Decompensated Cirrhosis: A Meta-Analysis

Objective: To evaluate the efficacy and safety of entecavir in Chinese patients with HBV-related decompensated cirrhosisMethods: The relevant randomized controlled trials were searched throughout PubMed, CBM, CNKI, Chinese VIP database and WanFang database. All articles were identified by a search from January 1990 to April 2011. Additional studies were identified by scrutiny of the reference lists of eligible articles. Trials comparing the efficacy of entecavir therapy versus conventional therapy or lamivudine therapy in Chinese patients with hepatitis B virus-related decompensated cirrhosis were included. Two investigators independently assessed the methodological quality of included trials and performed the data extraction. Meta-analysis was carried out with Review Manager Software 5.1. Subgroup analyses were used according to different treatment group.Results: Sixteen eligible trials including 980 patients were included and assessed. Among them eleven trials compared the efficacy of entecavir therapy with conventional therapy, seven trials compared the efficacy of entecavir therapy with lamivudine therapy. According to the results of meta-analysis, Entecavir therapy was remarkably more effective than conventional therapy in terms of mortality rates [OR=0.29, 95%CI(0.14, 0.58), P<0.05], HBV-DNA negative rates [OR=64.71, 95%CI(32.41, 129.19), P<0.05], and Child-Turcotte-Pugh scores [OR=-3.52, 95%CI(-4.61, -2.43), P<0.05 (at the 24 weeks of treatment); OR=-1.84, 95%CI(-2.76, -0.93),P<0.05 (at the 48 weeks of treatment), respectively]; The mortality rates and CTP scores of the entecavir therapy groups were almost similar to that of the lamivudine therapy groups (P>0.05), but the HBV-DNA negative rates of the entecavir therapy groups were significantly higher than that of the lamivudine therapy groups [OR=2.69, 95%CI(1.59, 4.55), P<0.05], and the resistance rates of the entecavir therapy groups were significantly lower as compared to the lamivudine therapy groups [OR=0.12, 95%CI(0.03, 0.39), P<0.05]. On the other hand, entecavir was well tolerated and no serious adverse events such as lactic acidosis, myopathy, neuropathy, were reported in Chinese patients in the entecavir therapy groups.Conclusions: Entecavir can improve liver function in patients with decompensated cirrhosis and reduce their mortality rates by suppressing HBV replication. Furthermore, entecavir was well tolerated and the resistance rates of the entecavir therapy groups were significantly lower than that of the lamivudine treatment groups. Therefore, Entecavir can be used as preferred agent in Chinese patients with HBV-related decompensated cirrhosis.