Evidence map›Paper›PMID 36620830›Full record

ReviewCureus2022

A Systematic Review on Current Trends in the Treatment of Chronic Hepatitis B to Predict Disease Remission and Relapse.

Samia Rauf R Butt, Travis Satnarine, Pranuthi Ratna, Aditi Sarker, Adarsh Srinivas Ramesh, Carlos Munoz, Dawood Jamil, Hadrian Hoang-Vu Tran, Mafaz Mansoor, Safeera Khan

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Samia Rauf R ButtGeneral Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Travis SatnarinePediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Pranuthi RatnaGeneral Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Aditi SarkerGeneral Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Adarsh Srinivas RameshInternal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Carlos MunozInternal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Dawood JamilInternal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Hadrian Hoang-Vu TranInternal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Mafaz MansoorGeneral Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Safeera KhanInternal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
California Institute of Behavioral Neurosciences and Psychology (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite decreasing the prevalence of chronic hepatitis B (CHB), it is still a major health care challenge. Current antiviral regimens aim to suppress hepatitis B virus (HBV) deoxyribonucleic acid (DNA) activity to prevent the risk of hepatic decompensation, liver cirrhosis, and hepatocellular carcinoma (HCC). Currently, pegylated interferon (Peg-IFN) and nucleos(t)ide analogs (NA) are the first-line choices of drugs. Peg-IFN is now discontinued due to its mode of application and side effects. NA is used once daily to suppress HBV DNA activity but has little effect on covalently closed circular DNA (cccDNA), so continuous long-term therapy is required to suppress HBV DNA. Due to this effect, disease remission, relapse, and even clinical flare are common phenomena after the end of treatment (EOT). This review aimed to analyze the current regimens for treating chronic hepatitis B. Their mode of action, duration of treatment, and events after stopping therapy. The review was performed using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) 2020 guidelines. A search was undertaken in PubMed, PubMed Central, Google Scholar, and ScienceDirect. Screening of articles was carried out to find relevant and appropriate articles. Articles were then quality-checked before inclusion. Our analysis showed that long-term finite therapy with nucleoside analogs could improve clinical outcomes and suppress viral DNA activity. However, a functional cure, loss of hepatitis B surface antigen (HBsAg), is rarely achieved. The decision to end treatment depends on quantitative HBsAg level (qHBsAg), alanine aminotransferase (ALT), HBV DNA (deoxyribonucleic acid), hepatitis B e antigen (HBeAg), and fibrosis assessment. It is concluded that patients with HBeAg negative without cirrhosis can be easily withdrawn from treatment if they have long-term viral remission and a high HBsAg loss rate. However, patients with positive HBeAg should continue treatment because there is a high chance of disease relapse and even acute flare. To predict whether patients will benefit from EOT, some immunomodulatory markers are studied, including interleukin (IL-20, IL-8), fas ligand (FASGL), and IFN gamma. Although these factors are reliable, none pose an independent effect on disease remission. Combination therapy (IFN alpha + oral nucleoside analogs) is promising but has clinical shortcomings.

Indexed as

chronic hepatitis b (chb)late-relapsenucleotide analogspeg-interferonremissiontreatment free remission

Identifiers

PMID36620830
PMCPMC9814228
OpenAlexW4311701474

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.