DSpace Repository

Comparative effectiveness of anti-viral drugs with dual activity for treating hepatitis B and HIV co-infected patients: a network meta-analysis

Show simple item record

dc.contributor.author Naing, Cho
dc.contributor.author Yong Poovorawan
dc.contributor.author Tong, Kew Siang
dc.date.accessioned 2019-06-13T09:13:34Z
dc.date.available 2019-06-13T09:13:34Z
dc.date.issued 2018-11-14
dc.identifier.citation BMC Infectious Diseases. Vol.18, Article No. 564 (2018), 11 pages en_US
dc.identifier.issn 1471-2334
dc.identifier.uri http://cuir.car.chula.ac.th/handle/123456789/62111
dc.description.abstract Background : There are randomized trials assessing a variety of antiviral drugs for hepatitis B virus (HBV), but the relative effectiveness of these drugs in the treatment of patients co-infected with human immunodeficiency virus (HIV) remains unclear. The objectives of the current study were to estimate and rank the relative effectiveness of antiviral drugs for treating HBV and HIV co-infected patients. Methods : Randomized trials, assessing the efficacy of antiviral drugs for HBV and HIV co-infected patients were searched in health-related databases. The methodological quality of the included trials was evaluated using the Cochrane risk of bias tool. Main outcome in this meta-analysis study was the success of treatment by antivirals as determined by virologic response. We performed pairwise and network meta-analysis of these trials and assessed the quality of evidence using the GRADE approach. Results : Seven randomized trials (329 participants) were included in this network meta-analysis study. A network geometry was formed with six treatment options including four antiviral drugs, adefovir (ADV), emtricitabine (FTC), lamivudine (LMV) and tenofovir disoproxil fumarate (TDF), combination treatment of TDF plus LMV, and placebo. The weighted percentage contributions of each comparison distributed fairly equally in the entire network of evidence. An assumption of consistency required for network meta-analysis was not violated (the global Wald test for inconsistency: Chi2(4) = 3.63, p = 0.46). The results of estimates showed no differences between the treatment regimens in terms of viral response for treating HBV and HIV co-infected patients, which spanned both benefit and harm (e.g. LMV vs TDF plus LMV: OR: 0.37, 95%CI: 0.06–2.41). Overall, the certainty of evidence was very low in all comparisons (e.g. LMV vs TDF plus LMV: 218 fewer per 1000,121 more to 602 fewer, very low certainty). Therefore, we remained uncertain to the true ranking of the antiviral treatments in HBV/ HIV co-infected patients. Conclusions : The findings suggest that the evidence is insufficient to provide guidance to the relative effectiveness of currently available antiviral drugs with dual activity in treating co-infection of HBV/HIV. Well-designed, large clinical trials in this field to address other important outcomes from different epidemiological settings are recommended. en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.relation.uri https://doi.org/10.1186/s12879-018-3506-x
dc.relation.uri https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3506-x
dc.rights © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) en_US
dc.title Comparative effectiveness of anti-viral drugs with dual activity for treating hepatitis B and HIV co-infected patients: a network meta-analysis en_US
dc.type Article en_US
dc.email.author No information provided
dc.email.author yong.p@chula.ac.th
dc.email.author No information provided
dc.subject.keyword Hepatitis B en_US
dc.subject.keyword HIV en_US
dc.subject.keyword Antiviral en_US
dc.subject.keyword Network meta-analysis en_US
dc.identifier.DOI 10.1186/s12879-018-3506-x


Files in this item

This item appears in the following Collection(s)

  • Foreign Journal Article [121]
    บทความวารสารภาษาต่างประเทศจากฐานข้อมูลออนไลน์ Free Open Access

Show simple item record