Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response

August 30, 2015 at 3:23 pm

Clinical Infectious Diseases SEP 15, 2015 V.61 N.5 P.730-740

Bryony Simmons, Jawaad Saleem, Katherine Heath, Graham S. Cooke, and Andrew Hill

1Division of Medicine, Imperial College London

2Pharmacology and Therapeutics, Liverpool University, United Kingdom

Correspondence: Bryony Simmons, MPH, St Mary’s Campus, Imperial College London, Norfolk Place, London W2 1PG, UK (bryony.simmons13@imperial.ac.uk).

Background

Achievement of a sustained virologic response (SVR) after treatment for Hepatitis C infection is associated with improved outcomes. This meta-analysis aimed to determine the impact of SVR on long-term mortality risk compared with nonresponders in a range of populations.

Methods

An electronic search identified all studies assessing all-cause mortality in SVR and non-SVR patients. Eligible articles were stratified into general, cirrhotic, and populations coinfected with human immunodeficiency virus. The adjusted hazard ratio (95% confidence interval [CI]) for mortality in patients achieving SVR vs non-SVR, and pooled estimates for the 5-year mortality in each group were calculated.

Results

31 studies (n = 33 360) were identified as suitable for inclusion. Median follow-up time was 5.4 years (interquartile range, 4.9–7.5) across all studies. The adjusted hazard ratio of mortality for patients achieving SVR vs non-SVR was 0.50 (95% CI, .37–.67) in the general population, 0.26 (95% CI, .18–.74) in the cirrhotic group, and 0.21 (.10–.45) in the coinfected group. The pooled 5-year mortality rates were significantly lower for patients achieving SVR compared with non-SVR in all 3 populations.

Conclusions

The results suggest that there is a significant survival benefit of achieving an SVR compared with unsuccessful treatment in a range of populations infected with hepatitis C virus.

PDF

http://cid.oxfordjournals.org/content/61/5/730.full.pdf

Entry filed under: Antivirales no HIV, Biología Molecular, Epidemiología, Hepatitis C, Infecciones virales, Meta-Análisis, Metodos diagnosticos, REVIEWS, Update. Tags: .

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