Abstrak (Ringkasan)

Influenza H5N1 is thought to be a likely causative agent for a future human influenza pandemic. Several types of H5N1 vaccine have been tested, including different doses and ad uvants, and a meta!analysis is needed to identify the best formulation. "e searched #edline, $mbase, the %ochrane &ibrary, and other online databases to 'ebruary, ())*, in any language for randomised trials comparing different H5N1 vaccines +ith or +ithout placebo in healthy adults. ,rimary outcomes +ere seroconversion, seroresponse, or both according to haemagglutination!inhibition and microneutralisation. Secondary outcomes +ere adverse events. -ecause of the large number of compared formulations, multiple! treatments meta!analysis +as used for primary outcomes. .irect!comparison meta! analyses +ere also done. "e included 1/ trials, +hich assessed 50 groups. "ith non! aluminium ad uvant, sufficiently high immunogenicity 1greater than 2)34 +as achieved even at 1( microg or less 1given as t+o doses of 5 microg or less4, and higher doses did not provide ma or improvements. Immunogenicity for non!ad uvanted and aluminium! ad uvanted formulations increased +ith increasing dose, but +as not sufficiently high. No serious vaccine!related adverse events +ere reported across *5)) participants. %urrently, H5N1 influenza vaccines +ith non!aluminium ad uvants might represent the best available option in a pandemic. &arge!scale studies are needed to verify the high immunogenicity of non!aluminium!ad uvanted vaccines that use very lo+ doses of antigen.