Efficacy of oral antiviral drugs to prevent mother-to-child transmission of hepatitis B virus: a network meta-analysis
Efficacy of oral antiviral drugs to prevent mother-to-child transmission of hepatitis B virus: a network meta-analysis
复制标题
口服抗病毒药物预防乙型肝炎病毒母婴传播的功效：网络荟萃分析
DOI：
10.1007/s12072-020-10024-2
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发表时间：
2020-03-04
影响因子：
6.6
通讯作者：
Yin, Wenwei
中科院分区：
文献类型：
--
作者：
Jia, Fang;Deng, Fuxue;Yin, Wenwei
背景B型肝炎是一个严重的全球性健康问题。B肝炎病毒（HBV）母婴传播（MTCT）是HBV感染流行的主要危险因素。口服抗病毒药物被推荐给高病毒血症的母亲，以减少HBV的母婴传播。目前的网络分析比较了有效的治疗方法，以防止MTCT的HBV. MethodsPubMed，Embase，Web的科学，Scopus和万方数据的电子数据库进行搜索合格的研究。配对荟萃分析和贝叶斯网络分析被应用到比较抗病毒药物的疗效。Results 75项研究，涉及12,740名孕妇有资格进行分析。配对分析显示，拉米夫定（OR 0.15，95%CI 0.09- 0.25，I-squared = 0%）、替比夫定（OR 0.07，95%CI 0.05- 0.10，I-squared = 0%）和替诺福韦（OR 0.07，95%CI 0.04- 0.13，I-squared = 0%）显著降低MTCT率。贝叶斯分析的基础上的排序概率的多重比较结果表明，替诺福韦（SUCRA = 96.83%）出现更有效的比其他两个drug. Conclusionadding主动和被动的免疫预防，拉米夫定，替比夫定和替诺福韦在高度病毒血症的母亲可以进一步降低HBV的MTCT。基于直接和间接证据，替诺福韦似乎比其他两种药物更有效地预防HBV母婴传播。
BackgroundHepatitis B is a serious global health problem. Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a major risk factor in the endemicity of HBV infection. Oral antiviral drugs are recommended to highly viremic mothers to decrease MTCT of HBV. The present network analysis compared the efficacy of available treatments to prevent the MTCT of HBV.MethodsThe electronic databases of PubMed, Embase, Web of Science, Scopus, and Wanfang data were searched for eligible studies. Pair-wise meta-analysis and Bayesian network analysis were applied to compare the efficacy of antiviral drugs.ResultsSeventy-five studies involving 12,740 pregnant females were eligible for analysis. On pair-wise analysis, lamivudine (OR 0.15, 95% CI 0.09–0.25,I-squared = 0%), telbivudine (OR 0.07, 95% CI 0.05–0.10,I-squared = 0%) and tenofovir (OR 0.07, 95% CI 0.04–0.13,I-squared = 0%) significantly decreased the MTCT rate. Results of multiple comparisons with ranking probability based on Bayesian analysis showed that tenofovir (SUCRA = 96.83%) appeared more effective than the two other drugs.ConclusionIn addition to active and passive immunoprophylaxis, lamivudine, telbivudine and tenofovir in highly viremic mothers can further decrease MTCT of HBV. Based on direct and indirect evidence, tenofovir appears to be more effective than the two other drugs in the prevention of HBV MTCT.