Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.
Virol J. 2018 Sep 10;15(1):139. doi: 10.1186/s12985-018-1050-3.
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.
目前，对于 HBV/HIV 合并感染患者，拉米夫定（LAM）联合替诺福韦酯（TDF）治疗与 LAM 单药治疗的疗效和安全性尚未达成共识。
我们在英文和中文数据库中进行了全面的文献检索。提取了所有相关的二分类和连续性变量，并将联合结局表示为风险比（RR）或标准化均数差（SMD）。
我们的分析纳入了 11 项符合条件的研究。对于 HBV 相关结局，联合治疗组患者中 HBV 不可检测的比例、血清丙氨酸氨基转移酶（ALT）正常化率和乙型肝炎 e 抗原（HBeAg）丢失率均高于单药治疗组（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）。此外，联合治疗组的 HIV RNA 阴转率高于单药治疗组（RR=1.26，95%CI：1.11-1.42，P=0.0003）。
LAM 联合 TDF 治疗在 HBV/HIV 合并感染患者中的疗效优于 LAM 单药治疗。随着时间的推移，这种差异变得更加明显。
