Histological efficacy of traditional Chinese medicine plus entecavir therapy for HBV-related liver fibrosis

Ting-Ting Zhu^1,2,#,
Yun-Kai Dai^2,3,#,
Xin Sun²,
Zhi-Min Zhao^2,4,
Feng Xing²,
Zheng-Xin Li^5,* and
Cheng-Hai Liu^2,4,*

Gastroenterology & Hepatology Research 2024;6(4):12

doi: 10.53388/ghr2024012

Published online: December 30, 2024

Author information

Citation: Zhu TT, Dai YK, Sun X, Zhao ZM, Xing F, Li ZX, et al. Histological efficacy of traditional Chinese medicine plus entecavir therapy for HBV-related liver fibrosis. Gastroenterol & Hepatol Res. 2024;6(4):12. doi: 10.53388/ghr2024012.

Abstract

Background/Aims

Traditional Chinese medicine (TCM) combined with antiviral therapy has been proven to be effective for liver fibrosis due to chronic hepatitis B (CHB) in clinical practice in China. However, the robust evidence is limited, and the validity of results has been controversial in the past. The current study is to evaluate the efficacy and safety of the combination therapy of TCM plus entecavir (ETV) in the management of HBV-associated liver fibrosis or cirrhosis.

Methods

Seven electronic databases were searched from inception to 10 August 2021. Primary outcome of this study was the regression of liver fibrosis; the secondary outcomes were a necro-inflammatory improvement, alanine aminotransferase (ALT), HBV DNA undetectable rate, HBeAg loss and HBeAg seroconversion. All the trials included were assessed by the Cochrane risk-of-bias tool.

Results

It showed that TCM plus ETV attenuated liver fibrosis or cirrhosis in chronic hepatitis B patients as compared to ETV monotherapy(OR = 1.65; 95% CI: 1.29~2.11; P < 0.000,1). There is no statistical difference between TCM plus ETV and ETV in histological activity index, HBV DNA undetectable rate, HBeAg loss, HBeAg seroconversion and adverse events(P<0.05).

Conclusion

The comprehensive evaluation showed that TCM combined with ETV treatment was safe for the patients with CHB, and better promoted the regression of liver fibrosis than ETV monotherapy. However, the standardized, rigorously designed, and large-scale randomized controlled trials (RCTs) were needed for further validation.

Keywords

traditional Chinese medicine, entecavir, HBV-related fibrosis or cirrhosis, meta-analysis, randomized controlled trials

Copyright © 2025 Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 License (CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Zhu TT, Dai YK, Sun X, Zhao ZM, Xing F, Li ZX, et al. Histological efficacy of traditional Chinese medicine plus entecavir therapy for HBV-related liver fibrosis. Gastroenterol & Hepatol Res. 2024;6(4):12. doi: 10.53388/ghr2024012.

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Received	Revised	Accepted	Published
			December 30, 2024

DOI http://dx.doi.org/10.53388/ghr2024012

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