The online version of this article (https://doi.org/10.1186/s12985-018-1050-3) contains supplementary material, which is available to authorized users.
Currently, there is no consensus on the efficacy and safety of lamivudine (LAM) plus tenofovir disoproxil fumarate (TDF) combination therapy versus lamivudine monotherapy in HBV/HIV coinfected patients.
A comprehensive literature search was performed in English and Chinese databases. Both relevant dichotomous and continuous variables were extracted, and the combined outcomes were expressed as a risk ratio (RR) or a standard mean difference (SMD).
Eleven eligible studies were included in our analysis. For HBV-relevant outcomes, the proportion of patients with undetectable HBV, the rates of serum alanine aminotransferase (ALT) normalization and hepatitis B e antigen (HBeAg) loss were higher in the combination therapy group than the monotherapy group (RR = 1.42, 95% CI: 1.14–1.76, P = 0.002; RR = 1.36, 95% CI: 1.17–1.58, P < 0.0001; RR = 2.74, 95% CI: 1.20–6.22, P = 0.02). In addition, the rate of HIV RNA-negative conversion was higher in the combination therapy group than the monotherapy group (RR = 1.26, 95% CI: 1.11–1.42, P = 0.0003).
LAM plus TDF combination therapy was more efficacious than LAM monotherapy in HBV/HIV coinfected patients. As time passes, this difference becomes more pronounced.
Additional file 1: Figure S1. Subgroup analyses by language. (TIF 7780 kb)12985_2018_1050_MOESM1_ESM.tif
Additional file 2: Figure S2. Subgroup analyses by study design. (TIF 7777 kb)12985_2018_1050_MOESM2_ESM.tif
Additional file 3: Figure S3. Subgroup analyses by areas of China. (TIF 7222 kb)12985_2018_1050_MOESM3_ESM.tif
Additional file 4: Figure S4. Effect of LAM + TDF vs. LAM on HBV DNA levels at the end of treatment. (TIF 3430 kb)12985_2018_1050_MOESM4_ESM.tif
Additional file 5: Figure S5. Effect of LAM + TDF vs. LAM on the rate of HBeAg loss. (TIF 1169 kb)12985_2018_1050_MOESM5_ESM.tif
Additional file 6: Figure S6. Galbraith plots of HBV virological response rate(A), levels of HBV DNA(B), subgroups analysis of southern China(C), RCTs(D), 24 weeks(E), and 48 weeks(F). (TIF 6228 kb)12985_2018_1050_MOESM6_ESM.tif
Additional file 7: Figure S7. Funnel plot for studies included for HBV virological responses. (TIF 516 kb)12985_2018_1050_MOESM7_ESM.tif
Alter MJ. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006;44:6–9. CrossRef
Diederich WE, Steuber H. Therapy of viral infections. Topics Med Chem. 2015;2:35–56.
Fischer J. Analogue-based drug discovery. Chemistry International -- Newsmagazine for IUPAC. 2010;32:12–5.
Sharp M, Interpharma D, Sharp M, Interpharma D, Celle L, Cloud S. Sharp M. WHO Model List of Essential Medicines: Interpharma D; 2011.
Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, Coppola N. Hepatitis B virusburden in developing countries. World J Gastroentero. 2015;21:11941. CrossRef
Stabinski L, Barnhart M, Kahn RJ, Hamm TE. Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings. J Acquir Immune Defic Syndr. 2015;3:274–85. CrossRef
Stuck AE, Rubenstein LZ, Wieland D, Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. 1998;316:469–77.
Jain MK, Comanor L, White C, Kipnis P, Elkin C, Leung K, Ocampo A, Attar N, Keiser P, Lee WM. Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response. J Viral Hepatitis. 2010;14:176–82. CrossRef
Wang L, Wiener J, Bulterys M, Wei X, Chen L, Liu W, Liang S, Shepard C, Wang L, Wang A. Hepatitis B virus (HBV) load response to 2 antiviral regimens, Tenofovir/lamivudine and lamivudine, in HIV/ HBV-Coinfected pregnant women in Guangxi, China: the Tenofovir in pregnancy (TiP) study. J Infect Dis. 2016;214:1695. CrossRefPubMed
Chen J-r. Clinical efficacy of tenofovir disoproxil combined with lamivudine in treating HIV with hepatitis B virus infected. Chin J of Clinical Rational Drug Use. 2017;10:21–2. [in Chinese]
Chen R-f, Zheng Y-f, Xu S-f, Yang Q-e, Lu Y-h, Jiang Y-m. A 72-week on-treatment efficacy of de novo combination of tenofovir plus lamivudine based highly active antiretroviral therapy for HBV-HIV coinfected patients. Chinese Journal of Clinical Infectious Diseases. 2013;6:153–6. [in Chinese]
Gao H-g. Tenofovir and Lamivudine in Treatment of AIDS Complicated with Hepatitis B Virus Infection. System Medicine. 2016;1:54–6. [in Chinese]
He Z-y. The clinical efficacy and safety of hepatitis B virus infection patients combined with acquired immune deficiency syndrome treated by tenofovir disoproxil combined lamivudine. Chinese Journal of Experimental and Clinical Infectious Diseases: Electronic Edition. 2015;9:100–2. [in Chinese]
Liu S-x. Observation of the efficacy of tenofovir combined with lamivudine in the treatment of AIDS with hepatitis B virus for 72 weeks. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2017;26:992–4. [in Chinese]
Luo J-f, Chen B, Yang S-x, Liu H-s, Hu Y-S, Lai Z-H, et al. Clinical observation of antiviral therapy against HIV infection with chronic hepatitis B virus infection. Contemporary Medicine. 2016;22:146–7. [in Chinese]
Zhou M. Therapeutic effect and safety analysis of tenofovir dipivoxil combined with lamivudine and efavirenz on HIV/HBV coinfection. Med. Inf. 2016;29:50–1. [in Chinese]
Zhou Y. Effect of tenofovir dipivoxil combined with lamivudine in the treatment of AIDS complicated with hepatitis B virus infection. Henan Medical Research. 2016;25:746–7. [in Chinese]
Avihingsanon A, Lewin SS, Chang JJ, Piyawat K, Napissanant N, Matthews GV, Dore GJ, Bowden S, Lange J, Ruxrungtham K. Efficacy of tenofovir disoproxil fumarate/emtricitabine compared with emtricitabine alone in antiretroviral-naive HIV-HBV coinfection in Thailand. Antivir Ther. 2010;15:917. CrossRefPubMed
Guettouche T, Hnatyszyn HJ. Chronic hepatitis B and viral genotype: the clinical significance of determining HBV genotypes. Antivir Ther. 2005;10:593–604. PubMed
Casado JL. Renal and bone toxicity with the use of Tenofovir: understanding at the end. AIDS Rev. 2016;18:59. PubMed
Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10:101–29. CrossRef
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2011;327:557–60. CrossRef
Galbraith RF. A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med. 2010;7:889–94. CrossRef
Wang SH, Chen PJ, Yeh SH. Gender disparity in chronic hepatitis B: mechanisms of sex hormones. Journal of Gastroenterology & Hepatology. 2015;30:1237. CrossRef
- Lamivudine plus tenofovir combination therapy versus lamivudine monotherapy for HBV/HIV coinfection: a meta-analysis
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II