Sustained virologic response to direct-acting antiviral therapy in patients with chronic hepatitis C and hepatocellular carcinoma: A systematic review and meta-analysis.

2-Naphthylamine Adolescent Adult Anilides / therapeutic use Antiviral Agents / therapeutic use Benzimidazoles / therapeutic use Carbamates / therapeutic use Carcinoma, Hepatocellular / complications Cyclopropanes Female Fluorenes / therapeutic use Hepacivirus / drug effects Hepatitis C, Chronic / complications Humans Isoquinolines / therapeutic use Lactams, Macrocyclic Liver Neoplasms / complications Liver Transplantation Macrocyclic Compounds / therapeutic use Male Proline / analogs & derivatives Ritonavir / therapeutic use Sofosbuvir / therapeutic use Sulfonamides / therapeutic use Sustained Virologic Response Uracil / analogs & derivatives Valine Young Adult

Asian HCC treatment Liver transplant Non-Asian Real-world analysis

Journal

Journal of hepatology

ISSN: 1600-0641

Titre abrégé: J Hepatol

Pays: Netherlands

ID NLM: 8503886

Informations de publication

Date de publication:
09 2019

Historique:

received: 23 07 2018

revised: 31 03 2019

accepted: 25 04 2019

pubmed: 17 5 2019

medline: 15 12 2020

entrez: 17 5 2019

Statut: ppublish

Résumé

The effect of hepatocellular carcinoma (HCC) on the response to interferon-free direct-acting antiviral (DAA) therapy in patients with chronic hepatitis C (CHC) infection remains unclear. Using a systematic review and meta-analysis approach, we aimed to investigate the effect of DAA therapy on sustained virologic response (SVR) among patients with CHC and either active, inactive or no HCC. PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from 1/1/2013 to 9/24/2018. The pooled SVR rates were computed using DerSimonian-Laird random-effects models. We included 49 studies from 15 countries, comprised of 3,341 patients with HCC and 35,701 without HCC. Overall, the pooled SVR was lower in patients with HCC than in those without HCC (89.6%, 95% CI 86.8-92.1%, I Overall, SVR rates were lower in patients with HCC, especially with active HCC, compared to those without HCC, though heterogeneity was high. Continued efforts are needed to aggressively screen, diagnose, and treat HCC to ensure higher CHC cure rates. There are now medications (direct-acting antivirals or "DAAs") that can "cure" hepatitis C virus, but patients with hepatitis C and liver cancer may be less likely to achieve cure than those without liver cancer. However, patients with liver cancer are also more likely to have advanced liver disease and risk factors that can decrease cure rates, so better controlled studies are needed to confirm these findings.

Sections du résumé

BACKGROUND & AIMS

METHODS

PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from 1/1/2013 to 9/24/2018. The pooled SVR rates were computed using DerSimonian-Laird random-effects models.

RESULTS

We included 49 studies from 15 countries, comprised of 3,341 patients with HCC and 35,701 without HCC. Overall, the pooled SVR was lower in patients with HCC than in those without HCC (89.6%, 95% CI 86.8-92.1%, I

CONCLUSION

Overall, SVR rates were lower in patients with HCC, especially with active HCC, compared to those without HCC, though heterogeneity was high. Continued efforts are needed to aggressively screen, diagnose, and treat HCC to ensure higher CHC cure rates.

LAY SUMMARY

There are now medications (direct-acting antivirals or "DAAs") that can "cure" hepatitis C virus, but patients with hepatitis C and liver cancer may be less likely to achieve cure than those without liver cancer. However, patients with liver cancer are also more likely to have advanced liver disease and risk factors that can decrease cure rates, so better controlled studies are needed to confirm these findings.

Identifiants

DOI: 10.1016/j.jhep.2019.04.017 PMID: 31096005

pubmed: 31096005

pii: S0168-8278(19)30279-X

doi: 10.1016/j.jhep.2019.04.017

pii:

doi:

Substances chimiques

Anilides 0

Antiviral Agents 0

Benzimidazoles 0

Carbamates 0

Cyclopropanes 0

Fluorenes 0

Isoquinolines 0

Lactams, Macrocyclic 0

Macrocyclic Compounds 0

Sulfonamides 0

ledipasvir, sofosbuvir drug combination 0

ombitasvir 2302768XJ8

Uracil 56HH86ZVCT

Proline 9DLQ4CIU6V

2-Naphthylamine CKR7XL41N4

dasabuvir DE54EQW8T1

Valine HG18B9YRS7

Ritonavir O3J8G9O825

paritaprevir OU2YM37K86

asunaprevir S9X0KRJ00S

Sofosbuvir WJ6CA3ZU8B

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

Pagination

473-485