Systematic Review with Meta-Analysis: Efficacy and Safety of Direct-Acting Antivirals for Chronic Hepatitis C Genotypes 5 and 6.
Open Access
- 11 November 2019
- journal article
- research article
- Published by Hindawi Limited in BioMed Research International
- Vol. 2019, 2301291-12
- https://doi.org/10.1155/2019/2301291
Abstract
Direct-acting antivirals (DAAs) are modern treatments for chronic hepatitis C infection, but majority of available evidence on its treatment effect covers genotypes 1 to 4. Therefore, the efficacy and safety of DAAs for genotypes 5 and 6 need to be analysed. Studies were identified from Medline, Scopus, and CENTRAL and a Chinese database CNKI, from inception until Dec 4, 2018. Clinical trials were included if they enrolled patients with genotypes 5 and/or 6 infection, any type of second-generation DAAs was studied, and sustained virological response was assessed at the 12th week after treatment (SVR12) as outcome measure. Meta-analysis using metaprop statistical program was applied for pooling proportions if data were sufficient (i.e., at least 2 studies). Thirteen studies were included in the analysis. Four studies assessed the efficacy of four DAA regimens in genotype 5 patients, which were mainly sofosbuvir (SOF) plus pegylated-interferon/ribavirin (PR) or other DAAs, with SVR12 ranging from 94.4% to 100%. Twelve studies assessed the efficacy of seven DAA regimens among genotype 6 patients, but only two DAA regimens (i.e., SOF + PR and SOF/ledipasvir) had sufficient data for pooling. The pooled SVR12 rates (95% CI) were 99.6% (92.2 to 100) for SOF + PR and 99.2% (96.5 to 100) for SOF/ledipasvir. No treatment-related serious adverse event was reported, while the nonserious adverse events were comparable to other genotypes. In conclusion, DAAs are effective and may be safe for the treatment of chronic hepatitis C genotypes 5 and 6. However, our evidence is based on noncomparative studies; hence, further larger-scale randomized controlled trials in these genotypes are still required.Keywords
Funding Information
- Mahidol University
This publication has 44 references indexed in Scilit:
- Update on the treatment of hepatitis C genotypes 2–6Current Opinion in Infectious Diseases, 2014
- Global epidemiology and genotype distribution of the hepatitis C virus infectionJournal of Hepatology, 2014
- Global distribution and prevalence of hepatitis C virus genotypesHepatology, 2014
- HCV direct‐acting antiviral agents: the best interferon‐free combinationsLiver International, 2013
- Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: Updated criteria and genotype assignment web resourceHepatology, 2013
- Understanding the hepatitis C virus life cycle paves the way for highly effective therapiesNature Medicine, 2013
- Sofosbuvir with pegylated interferon alfa-2a and ribavirin for treatment-naive patients with hepatitis C genotype-1 infection (ATOMIC): an open-label, randomised, multicentre phase 2 trialThe Lancet, 2013
- Sofosbuvir for Previously Untreated Chronic Hepatitis C InfectionNew England Journal of Medicine, 2013
- Five large Chinese biomedical bibliographic databases: accessibility and coverageHealth Information and Libraries Journal, 2008
- What contributions do languages other than English make on the results of meta-analyses?Journal of Clinical Epidemiology, 2000