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Meta-Analysis
. 2015 Sep 1;61(5):730-40.
doi: 10.1093/cid/civ396. Epub 2015 May 17.

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

Bryony Simmons  1 , Jawaad Saleem  1 , Katherine Heath  1 , Graham S Cooke  1 , Andrew Hill  2
Affiliations
Meta-Analysis

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

Bryony Simmons et al. Clin Infect Dis. .

Abstract

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.

Keywords: hepatitis C; mortality; survival; sustained virologic response.

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Figures

Figure 1.
Figure 1.
Five-year mortality rates (95% confidence interval) for sustained virologic response (SVR) vs non-SVR groups for each cohort.
Figure 2.
Figure 2.
Forest plot of studies and pooled estimates of adjusted hazard ratios of mortality in those achieving sustained virologic response (SVR) vs non-SVR. In (A) the general cohort; (B) the cirrhotic cohort; and (C) the coinfected cohort. Abbreviations: CI, confidence interval; ES, effect size.
See this image and copyright information in PMC

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