Six studies were included in the meta-analysis (n=317): two prospective (n=79) and four retrospective (n=238). All used historical controls. Sample size ranged from 19 to 117 participants.
There was no evidence of statistical heterogeneity or publication bias.
Hepatitis B immunoglobulin combined with lamivudine was associated with reduced risk of: hepatitis B virus recurrence (six studies), odds ratio 0.08 (95% confidence interval: 0.03, 0.21, p<0.001); hepatitis B virus-related death (three studies), odds ratio 0.08 (95% confidence interval: 0.02, 0.33, P<0.001); and all-cause mortality (three studies), odds ratio 0.21 (95% confidence interval: 0.06, 0.82, p=0.02) compared with hepatitis B immunoglobulin alone.
The rate of recurrence of hepatitis B virus was 4.1 per cent with combination therapy compared with 36.1 per cent for hepatitis B immunoglobulin (number needed to treat was four). Hepatitis B virus-related death was 0.8 per cent compared with 15.1 per cent hepatitis B immunoglobulin (number needed to treat was seven). All-cause mortality was 5.1 per cent with combination therapy compared with 22.2 per cent with hepatitis B immunoglobulin (number needed to treat was six).
No studies reported harmful effects of combination therapy.