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Comparison 1 Bile acids for acute hepatitis B, Outcome 1 Risk of having positive serum HBsAg at the end of treatment.
Figures and Tables -
Analysis 1.1

Comparison 1 Bile acids for acute hepatitis B, Outcome 1 Risk of having positive serum HBsAg at the end of treatment.

Comparison 1 Bile acids for acute hepatitis B, Outcome 2 Risk of having positive HBsAg at the end of follow‐up.
Figures and Tables -
Analysis 1.2

Comparison 1 Bile acids for acute hepatitis B, Outcome 2 Risk of having positive HBsAg at the end of follow‐up.

Comparison 1 Bile acids for acute hepatitis B, Outcome 3 Serum DNA (pg/ml) level at the end of treatment.
Figures and Tables -
Analysis 1.3

Comparison 1 Bile acids for acute hepatitis B, Outcome 3 Serum DNA (pg/ml) level at the end of treatment.

Comparison 1 Bile acids for acute hepatitis B, Outcome 4 Serum DNA (pg/ml) level at the end of follow‐up.
Figures and Tables -
Analysis 1.4

Comparison 1 Bile acids for acute hepatitis B, Outcome 4 Serum DNA (pg/ml) level at the end of follow‐up.

Comparison 1 Bile acids for acute hepatitis B, Outcome 5 Risk of abnormal serum ALT at the end of treatment.
Figures and Tables -
Analysis 1.5

Comparison 1 Bile acids for acute hepatitis B, Outcome 5 Risk of abnormal serum ALT at the end of treatment.

Comparison 1 Bile acids for acute hepatitis B, Outcome 6 Risk of abnormal serum ALT at the end of follow‐up.
Figures and Tables -
Analysis 1.6

Comparison 1 Bile acids for acute hepatitis B, Outcome 6 Risk of abnormal serum ALT at the end of follow‐up.

Comparison 1 Bile acids for acute hepatitis B, Outcome 7 Risk of abnormal serum GGT at the end of treatment.
Figures and Tables -
Analysis 1.7

Comparison 1 Bile acids for acute hepatitis B, Outcome 7 Risk of abnormal serum GGT at the end of treatment.

Comparison 1 Bile acids for acute hepatitis B, Outcome 8 Risk of abnormal serum GGT at the end of follow‐up.
Figures and Tables -
Analysis 1.8

Comparison 1 Bile acids for acute hepatitis B, Outcome 8 Risk of abnormal serum GGT at the end of follow‐up.

Comparison 2 Bile acids for chronic hepatitis B, Outcome 1 Risk of abnormal serum ALT at the end of treatment.
Figures and Tables -
Analysis 2.1

Comparison 2 Bile acids for chronic hepatitis B, Outcome 1 Risk of abnormal serum ALT at the end of treatment.

Comparison 2 Bile acids for chronic hepatitis B, Outcome 2 Serum ALT (IU/L) at the end of treatment.
Figures and Tables -
Analysis 2.2

Comparison 2 Bile acids for chronic hepatitis B, Outcome 2 Serum ALT (IU/L) at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 1 Risk of having serum HCV RNA at the end of treatment.
Figures and Tables -
Analysis 3.1

Comparison 3 Bile acids for chronic hepatitis C, Outcome 1 Risk of having serum HCV RNA at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 2 Sensitivity analyses: Risk of having serum HCV RNA at the end of treatment ‐ Duration of treatment.
Figures and Tables -
Analysis 3.2

Comparison 3 Bile acids for chronic hepatitis C, Outcome 2 Sensitivity analyses: Risk of having serum HCV RNA at the end of treatment ‐ Duration of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 3 Risk of having serum HCV RNA at the end of follow‐up.
Figures and Tables -
Analysis 3.3

Comparison 3 Bile acids for chronic hepatitis C, Outcome 3 Risk of having serum HCV RNA at the end of follow‐up.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 4 Sensitivity analyses: Risk of having serum HCV RNA at the end of follow‐up ‐ Duration of treatment.
Figures and Tables -
Analysis 3.4

Comparison 3 Bile acids for chronic hepatitis C, Outcome 4 Sensitivity analyses: Risk of having serum HCV RNA at the end of follow‐up ‐ Duration of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 5 Risk of cirrhosis at the end of treatment.
Figures and Tables -
Analysis 3.5

Comparison 3 Bile acids for chronic hepatitis C, Outcome 5 Risk of cirrhosis at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 6 Risk of abnormal serum ALT at the end of treatment.
Figures and Tables -
Analysis 3.6

Comparison 3 Bile acids for chronic hepatitis C, Outcome 6 Risk of abnormal serum ALT at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 7 Sensitivity analyses: Risk of abnormal serum ALT at the end of treatment ‐ Duration of treatment.
Figures and Tables -
Analysis 3.7

Comparison 3 Bile acids for chronic hepatitis C, Outcome 7 Sensitivity analyses: Risk of abnormal serum ALT at the end of treatment ‐ Duration of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 8 Risk of abnormal serum ALT at the end of follow‐up.
Figures and Tables -
Analysis 3.8

Comparison 3 Bile acids for chronic hepatitis C, Outcome 8 Risk of abnormal serum ALT at the end of follow‐up.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 9 Sensitivity analyses: Risk of abnormal serum ALT at the end of follow‐up ‐ Duration of treatment.
Figures and Tables -
Analysis 3.9

Comparison 3 Bile acids for chronic hepatitis C, Outcome 9 Sensitivity analyses: Risk of abnormal serum ALT at the end of follow‐up ‐ Duration of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 10 Serum ALT (IU/L) at the end of treatment.
Figures and Tables -
Analysis 3.10

Comparison 3 Bile acids for chronic hepatitis C, Outcome 10 Serum ALT (IU/L) at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 11 Serum AST (IU/L) at the end of treatment.
Figures and Tables -
Analysis 3.11

Comparison 3 Bile acids for chronic hepatitis C, Outcome 11 Serum AST (IU/L) at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 12 Serum GGT (IU/L) at the end of treatment.
Figures and Tables -
Analysis 3.12

Comparison 3 Bile acids for chronic hepatitis C, Outcome 12 Serum GGT (IU/L) at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 13 Portal and periportal inflammation scores at the end of treatment.
Figures and Tables -
Analysis 3.13

Comparison 3 Bile acids for chronic hepatitis C, Outcome 13 Portal and periportal inflammation scores at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 14 Knodell score at the end of treatment.
Figures and Tables -
Analysis 3.14

Comparison 3 Bile acids for chronic hepatitis C, Outcome 14 Knodell score at the end of treatment.

Comparison 3 Bile acids for chronic hepatitis C, Outcome 15 Adverse events caused by bile acid.
Figures and Tables -
Analysis 3.15

Comparison 3 Bile acids for chronic hepatitis C, Outcome 15 Adverse events caused by bile acid.

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 1 All cause mortality at the end of treatment.
Figures and Tables -
Analysis 4.1

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 1 All cause mortality at the end of treatment.

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 2 Risk of abnormal serum ALT at the end of treatment.
Figures and Tables -
Analysis 4.2

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 2 Risk of abnormal serum ALT at the end of treatment.

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 3 Improvement of total Knodell score at the end of treatment.
Figures and Tables -
Analysis 4.3

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 3 Improvement of total Knodell score at the end of treatment.

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 4 Number of graft rejection at the end of treatment.
Figures and Tables -
Analysis 4.4

Comparison 4 Bile acids for chronic viral hepatitis among heart transplanted patients, Outcome 4 Number of graft rejection at the end of treatment.

Comparison 1. Bile acids for acute hepatitis B

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Risk of having positive serum HBsAg at the end of treatment Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.17, 0.92]

1.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.17, 0.92]

2 Risk of having positive HBsAg at the end of follow‐up Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.23 [0.05, 1.00]

2.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.23 [0.05, 1.00]

3 Serum DNA (pg/ml) level at the end of treatment Show forest plot

1

59

Mean Difference (IV, Fixed, 95% CI)

‐574.05 [‐1148.71, 0.61]

3.1 UDCA versus placebo

1

59

Mean Difference (IV, Fixed, 95% CI)

‐574.05 [‐1148.71, 0.61]

4 Serum DNA (pg/ml) level at the end of follow‐up Show forest plot

1

59

Mean Difference (IV, Fixed, 95% CI)

‐954.73 [‐1813.71, ‐95.75]

4.1 UDCA versus placebo

1

59

Mean Difference (IV, Fixed, 95% CI)

‐954.73 [‐1813.71, ‐95.75]

5 Risk of abnormal serum ALT at the end of treatment Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.12, 1.02]

5.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.12, 1.02]

6 Risk of abnormal serum ALT at the end of follow‐up Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.06, 1.21]

6.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.06, 1.21]

7 Risk of abnormal serum GGT at the end of treatment Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.11, 0.90]

7.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.11, 0.90]

8 Risk of abnormal serum GGT at the end of follow‐up Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.06, 1.21]

8.1 UDCA versus placebo

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.06, 1.21]

Figures and Tables -
Comparison 1. Bile acids for acute hepatitis B
Comparison 2. Bile acids for chronic hepatitis B

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Risk of abnormal serum ALT at the end of treatment Show forest plot

1

112

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.45, 0.94]

1.1 UDCA versus no intervention

1

112

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.45, 0.94]

2 Serum ALT (IU/L) at the end of treatment Show forest plot

1

112

Mean Difference (IV, Fixed, 95% CI)

‐14.94 [‐21.20, ‐8.68]

2.1 UDCA versus no intervention

1

112

Mean Difference (IV, Fixed, 95% CI)

‐14.94 [‐21.20, ‐8.68]

Figures and Tables -
Comparison 2. Bile acids for chronic hepatitis B
Comparison 3. Bile acids for chronic hepatitis C

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Risk of having serum HCV RNA at the end of treatment Show forest plot

13

837

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.91, 1.07]

1.1 UDCA versus placebo or no intervention

2

106

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.84, 1.21]

1.2 UDCA plus interferon versus interferon

11

731

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.90, 1.08]

2 Sensitivity analyses: Risk of having serum HCV RNA at the end of treatment ‐ Duration of treatment Show forest plot

13

837

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.91, 1.07]

2.1 Short treatment duration (less than 12 months)

8

444

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.83, 1.04]

2.2 Long treatment duration (12 months or more)

5

393

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.92, 1.19]

3 Risk of having serum HCV RNA at the end of follow‐up Show forest plot

10

676

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.87, 1.00]

3.1 UDCA plus interferon versus interferon

10

676

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.87, 1.00]

4 Sensitivity analyses: Risk of having serum HCV RNA at the end of follow‐up ‐ Duration of treatment Show forest plot

10

676

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.87, 1.00]

4.1 Short treatment duration (less than 12 months)

5

283

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.87, 1.12]

4.2 Long treatment duration (12 months or more)

5

393

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.83, 0.99]

5 Risk of cirrhosis at the end of treatment Show forest plot

1

103

Risk Ratio (M‐H, Fixed, 95% CI)

1.79 [0.93, 3.47]

5.1 UDCA plus interferon versus interferon

1

103

Risk Ratio (M‐H, Fixed, 95% CI)

1.79 [0.93, 3.47]

6 Risk of abnormal serum ALT at the end of treatment Show forest plot

21

1582

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.77, 0.90]

6.1 UDCA versus placebo or no intervention

3

239

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.69, 0.88]

6.2 UDCA plus interferon versus interferon

15

1007

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.73, 0.91]

6.3 TUDCA plus interferon versus interferon

2

166

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.70, 1.24]

6.4 UDCA plus glycyrrhizin versus glycyrrhizin

1

170

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.75, 1.24]

7 Sensitivity analyses: Risk of abnormal serum ALT at the end of treatment ‐ Duration of treatment Show forest plot

21

1582

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.77, 0.90]

7.1 Short treatment duration (less than 12 months)

16

1189

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.76, 0.92]

7.2 Long treatment duration (12 months or more)

5

393

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.69, 0.99]

8 Risk of abnormal serum ALT at the end of follow‐up Show forest plot

13

929

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.85, 0.97]

8.1 UDCA plus interferon versus interferon

12

869

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.84, 0.97]

8.2 TUDCA plus interferon versus interferon

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.68, 1.47]

9 Sensitivity analyses: Risk of abnormal serum ALT at the end of follow‐up ‐ Duration of treatment Show forest plot

13

929

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.85, 0.97]

9.1 Short treatment duration (less than 12 months)

7

495

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.84, 1.00]

9.2 Long treatment duration (12 months or more)

6

434

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.80, 1.00]

10 Serum ALT (IU/L) at the end of treatment Show forest plot

5

386

Mean Difference (IV, Fixed, 95% CI)

‐1.29 [‐3.16, 0.59]

10.1 UDCA versus placebo or no intervention

2

162

Mean Difference (IV, Fixed, 95% CI)

‐26.78 [‐39.65, ‐13.92]

10.2 TUDCA versus placebo or no intervention

3

224

Mean Difference (IV, Fixed, 95% CI)

‐0.73 [‐2.63, 1.16]

11 Serum AST (IU/L) at the end of treatment Show forest plot

2

146

Mean Difference (IV, Fixed, 95% CI)

‐25.16 [‐34.02, ‐16.30]

11.1 UDCA versus placebo or no intervention

1

61

Mean Difference (IV, Fixed, 95% CI)

‐20.70 [‐32.08, ‐9.32]

11.2 TUDCA versus placebo or no intervention

1

85

Mean Difference (IV, Fixed, 95% CI)

‐32.0 [‐46.10, ‐17.90]

12 Serum GGT (IU/L) at the end of treatment Show forest plot

5

302

Mean Difference (IV, Fixed, 95% CI)

‐14.09 [‐17.34, ‐10.84]

12.1 UDCA versus placebo or no intervention

3

184

Mean Difference (IV, Fixed, 95% CI)

‐13.14 [‐16.48, ‐9.80]

12.2 TUDCA versus placebo or no intervention

2

118

Mean Difference (IV, Fixed, 95% CI)

‐31.23 [‐45.45, ‐17.01]

13 Portal and periportal inflammation scores at the end of treatment Show forest plot

3

167

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.15, 0.24]

13.1 UDCA plus interferon versus interferon

3

167

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.15, 0.24]

14 Knodell score at the end of treatment Show forest plot

2

133

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.08, 0.31]

14.1 UDCA plus interferon versus interferon

2

133

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.08, 0.31]

15 Adverse events caused by bile acid Show forest plot

3

254

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.56, 2.46]

15.1 UDCA plus interferon versus interferon

2

179

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.49, 2.28]

15.2 UDCA versus no intervention

1

75

Risk Ratio (M‐H, Fixed, 95% CI)

2.75 [0.16, 48.61]

Figures and Tables -
Comparison 3. Bile acids for chronic hepatitis C
Comparison 4. Bile acids for chronic viral hepatitis among heart transplanted patients

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 All cause mortality at the end of treatment Show forest plot

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

2.33 [0.67, 8.18]

2 Risk of abnormal serum ALT at the end of treatment Show forest plot

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.76, 1.22]

3 Improvement of total Knodell score at the end of treatment Show forest plot

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

0.46 [0.20, 1.05]

4 Number of graft rejection at the end of treatment Show forest plot

1

60

Risk Ratio (M‐H, Fixed, 95% CI)

2.67 [0.78, 9.09]

Figures and Tables -
Comparison 4. Bile acids for chronic viral hepatitis among heart transplanted patients