SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
Different Nucleos(t)ide Analogs in Resected Hepatitis B Virus-Associated Hepatocellular Carcinoma: A Systematic Review
Provisionally accepted
- 1Department of Nursing, Nantong Health College of Jiangsu Province, Nantong, China
- 2Department of Laboratory Medicine, Haimen Hospital Affiliated to Xinglin College of Nantong University, Nantong, China
- 3Department of General Surgery, The Sixth People’s Hospital of Nantong, Nantong, China
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Background: To evaluate the effects of different types of nucleos(t)ide analogs on the survival rate of patients with hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC) after radical resection through a network meta-analysis. Methods: PubMed, Embase, the Cochrane Library, and CNKI databases were searched up to March 6, 2024. The NOS was used to assess the risk of bias in cohort studies, while the ROB tool in Review Manager was employed for randomized controlled trials. Data on overall survival (OS) and recurrence-free survival(RFS) were extracted from the literature to pool hazard ratios (HRs) and corresponding 95% CrIs. Meta-analysis was performed via R. Results: 24 studies involving 9,787 HBV-HCC patients were included. Compared with the control group, antiviral therapies using telbivudine(HR[95%CrI]=0.23[0.12,0.44]), tenofovir disoproxil fumarate(HR[95%CrI]=0.40[0.30,0.52]), lamivudine (HR[95%CrI] =0.50[0.34, 0.75]), adefovir(HR[95%CrI]=0.55[0.38,0.79]), and entecavir(HR [95%CrI] =0.55[0.43,0.71]) significantly improved OS. Among these, telbivudine (98.22%) and tenofovir disoproxil fumarate (76.12%) demonstrated superior effects in improving OS. Compared with the control group, antiviral therapies using telbivudine (HR[95%CrI]=0.45 [0.28,0.70]), tenofovir disoproxil fumarate (HR[95%CrI]=0.52[0.44,0.62]), entecavir (HR[95%CrI]=0.65[0.55,0.77]),adefovir(HR[95%CrI]=0.79[0.65,0.94]),and lamivudine (HR[95%CrI]=0.82[0.71, 0.94]) significantly improved RFS. Telbivudine(SUCRA, 93.22%) and tenofovir disoproxil fumarate(SUCRA, 85.37%) exhibited superior effects in improving RFS. Conclusion: When compared to other nucleos(t)ide analogs, telbivudine and tenofovir disoproxil fumarate exhibited the most notable effects.
Keywords: Hepatitis B virus, Hepatocellular Carcinoma, Antiviral therapy, Nucleos(t)ideanalogs, Recurrence-free survival
Received: 30 Jun 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Qiu, Zhang, Xu and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Songhui Xue, miaomiao20140319@163.com
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