Virologic response at week 8 of combined treatment as a predictor of sustained virologic response in non rapid virologic response, chronic HCV genotype 4 infected patients

Monis, Ali; Monis, Ahmed; Swaff, Reham Al

doi:10.1016/j.ejmhg.2012.03.002

Cited by 2 publications

(5 citation statements)

References 16 publications

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“…Sub-group-analysis by prospective and retrospective studies showed similar SVR rates: 53% (CI: 50–56%) in forty-three prospective studies[10, 11, 13–16, 18, 27, 28, 34, 38–42, 46, 48, 53–56, 62, 63, 65–67, 69, 72, 73, 75–78, 80, 81, 83, 84, 88, 90, 91, 93, 95, 96] and 53% (CI: 46–59%) in eight retrospective studies[12, 35, 37, 45, 59, 71, 79, 85]. Significant heterogeneity was observed in both sub-group analyses with I 2 >50% (Figure 4).…”

Section: Resultsmentioning

confidence: 95%

“…There were 51 studies with a total of 11,102 HCV-4 patients included in the primary analysis (Table 1)[10–16, 18, 27, 28, 34, 35, 37–42, 45, 46, 48, 53–56, 59, 62, 63, 65–67, 69, 71–73, 75–81, 83–85, 88, 90, 91, 93, 95, 96]. The majority of studies (40/51, 78%) originated from the Middle East[10–13, 15, 16, 18, 27, 28, 34, 35, 37, 40–42, 45, 46, 53–56, 59, 62, 63, 66, 67, 69, 72, 75, 78, 80, 81, 83–85, 88, 91, 95] and Europe (9/51, 18%)[14, 38, 39, 65, 71, 76, 79, 93, 96].…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (40/51, 78%) originated from the Middle East[10–13, 15, 16, 18, 27, 28, 34, 35, 37, 40–42, 45, 46, 53–56, 59, 62, 63, 66, 67, 69, 72, 75, 78, 80, 81, 83–85, 88, 91, 95] and Europe (9/51, 18%)[14, 38, 39, 65, 71, 76, 79, 93, 96]. One originated in Cameroon[77] and one multi-center study was conducted in 19 countries[73].…”

Section: Resultsmentioning

confidence: 99%

“…When comparing RCTs versus non-RCT studies, we observed a pooled SVR rate of 60% (CI: 53–68%) in the six RCTs[10, 13, 16, 18, 54, 93] compared to 52% (CI: 49–55%) in 45 non-RCTs[11, 12, 14, 15, 27, 28, 34, 35, 37–42, 45, 46, 48, 53, 55, 56, 59, 62, 63, 65–67, 69, 71–73, 75–81, 83–85, 88, 90, 91, 95, 96] (Figure 3). This finding was statistically significant with p =0.043.…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis

Yee

Nguyen

Zhang

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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Background The burden of hepatitis C virus genotype 4 (HCV-4) is high in Africa and East Mediterranean countries. Previous reports estimate sustained virologic response (SVR) rates in HCV-4 to be ~20–70%. However, many of these studies are limited by different study designs and small sample sizes. Aim Our aim was to evaluate treatment outcome and host/viral factors on SVR in HCV-4 patients treated with pegylated interferon and ribavirin (PEG IFN+RBV) in a systematic and quantitative fashion. Methods A comprehensive literature search in MEDLINE and EMBASE for ‘genotype 4’ was conducted in November 2013. Abstracts from AASLD, APASL, DDW, and EASL in 2012/2013 were reviewed. Inclusion criteria were original studies with ≥25 treatment-naïve HCV-4 patients treated with PEG IFN+RBV. Exclusion criteria were co-infection with HIV, HBV, or other genotypes. Effect sizes were calculated using random-effects models. Heterogeneity was determined by Cochrane Q-test (p-value <0.05) and I-squared statistic (>50%). Results We included 51 studies (11,102 HCV-4 patients) in the primary analysis. Pooled SVR was 53% (95% CI: 50–55%) (Q-statistic = 269.20, p<0.05; I2 = 81.43). On sub-group analyses, SVR was significantly associated with lower viral load, OR 3.05 (CI 1.80–5.17, p<0.001); mild fibrosis, OR 3.17 (CI 2.19–4.59, p<0.001); and favorable IL28B polymorphisms, rs12979860 CC versus CT/TT, OR 4.70 (CI 2.87–7.69, p<0.001), and rs8099917 TT versus GT/GG, OR 5.21 (CI 2.31–11.73, p<0.001). Conclusions HCV-4 patients treated with PEG IFN+RBV may expect SVR rate of ~50%. Lower viral load, mild fibrosis, and favorable IL28B (rs12979860 CC and rs8099917 TT) are positively associated with SVR.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meta-analysis

Yee

Nguyen

Zhang

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…Eighty-four studies were closely reviewed. 7 10–59 61–93 A total of 79 studies were excluded for the following reasons: 45 studies did not have direct comparison arms of HCV-1, 2, and/or 3; 7 10–13 15–31 33–39 41 44 45 47–59 14 studies did not have accessible treatment outcomes data; 61 62 67 70 72 76 78 79 82 84 85 87 92 93 6 studies were redundant; 71 73 75 80 86 91 4 studies were not relevant; 63 68 77 88 3 studies included patients coinfected with other conditions, including hepatitis B virus, HIV or other liver diseases; 69 81 83 3 studies did not assess treatment-naïve patients; 64 65 89 2 studies did not contain original data; 74 90 1 study did not meet our minimum sample size requirement of at least 25 HCV patients; 66 1 study did not include patients treated for 48 weeks. 40 A total of five studies met all eligibility criteria and were included in the primary analysis.…”

Section: Resultsmentioning

confidence: 99%

Sustained virological response and its treatment predictors in hepatitis C virus genotype 4 compared to genotypes 1, 2, and 3: a meta-analysis

Yee

Nguyen

Zhang

et al. 2015

BMJ Open Gastroenterol

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BackgroundPegylated interferon and ribavirin (PEG-IFN+RBV) may be more cost-effective than direct-acting antivirals in resource-limited settings. Current literature suggests sustained virological response (SVR) in hepatitis C virus genotype 4 (HCV-4) is similar to genotype 1 (HCV-1), but worse than 2 and 3 (HCV-2/3). However, few studies have compared treatment response between these groups and these have been limited by small sample sizes with heterogeneous designs. We performed a meta-analysis of SVR predictors in HCV-4 versus HCV-1, 2, and 3 patients treated with PEG-IFN+RBV.MethodsIn November 2013, we searched for ‘genotype 4’ in MEDLINE/EMBASE databases and scientific conferences. We included original articles with ≥25 treatment-naïve HCV-4 and comparisons to HCV-1, 2, and/or 3 patients treated with PEG-IFN+RBV. Random effects modelling was used with heterogeneity defined by Cochrane Q-test (p value<0.10) and I2 statistic (>50%).ResultsFive studies with 20 014 patients (899 HCV-4; 12 033 HCV-1; and 7082 HCV-2/3 patients) were included. SVR was 53% (CI 43% to 62%) for HCV-4, 44% (CI 40% to 47%) for HCV-1; and 73% (CI 58% to 84%) for HCV-2/3. SVR with EVR (early virological response) was 75% (CI 61% to 86%) in HCV-4; 64% (CI 46% to 79%) in HCV-1; and 85% (CI 71% to 93%) in HCV-2/3. SVR without EVR was 10% (CI 6% to 17%) for HCV-4; 13% (CI 12% to 15%) for HCV-1; and 23% (CI 16% to 33%) for HCV-2/3.ConclusionsSVR rates are similar in HCV-4 (∼50%) and HCV-1 (∼40%). Lack of EVR is a good stopping rule for HCV-4 and HCV-1 since only 10% subsequently achieve SVR. In HCV-4 patients with EVR, three-quarters can expect to achieve SVR with PEG-IFN+RBV.

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Virologic response at week 8 of combined treatment as a predictor of sustained virologic response in non rapid virologic response, chronic HCV genotype 4 infected patients

Cited by 2 publications

References 16 publications

Meta-analysis

Meta-analysis

Sustained virological response and its treatment predictors in hepatitis C virus genotype 4 compared to genotypes 1, 2, and 3: a meta-analysis

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