A comprehensive long-term prognosis of chronic hepatitis C patients with antiviral therapy: a meta-analysis of studies from 2008 to 2014

Abstract

Context: Attaining a sustained virological response with antiviral therapy is a sign of clinical cure for chronic hepatitis C patients. The aim of this meta-analysis was to evaluate the long-term efficiency and outcome of antiviral therapy in patients with hepatitis C who attained a sustained virological response.

Evidence acquisition: A literature search was performed on published articles between January 2008 and February 2014. Patients with Hepatitis C who received interferon with or without ribavirin therapy were enrolled. Relative risks were estimated using either fixed or random effect models.

Results: Patients who attained sustained virological response had a less risk (85%) for all-cause mortality and about 63% reduced risk of hepatocellular carcinoma incidence than those who did not achieve sustained virological response. Based on deeply analysis, the stage of liver fibrosis was a risk factor at baseline for the incidence of hepatocellular carcinoma.

Conclusions: Sustained virological response can reduce all-cause mortality and the incidence of hepatocellular carcinoma of patients with hepatitis C. Advanced liver fibrosis is still a risk factor for the incidence of hepatocellular carcinoma, in spite of hepatitis C patients attained a sustained virological response.

Keywords: Antiviral Therapy; Chronic Hepatitis C; Meta-Analysis.

Figure 1.. The Selection Process in the Flow Diagram

Figure 2.. Risk of All-Cause Mortality Between SVR And non-SVR

The heterogeneity of the studies was tested using χ² test and I² statistic. If a significant heterogeneity (χ² test, P < 0.10) was found, the random-effect model was used in the analysis, and if the heterogeneity was not significant (χ² test, P ≥ 0.10), the fixed-effect model was used. Studies with substantial heterogeneity (I² ≥ 50%) are not suitable for meta-analysis.

Figure 3.. Risk of HCC Between SVR and non-SVR

The heterogeneity of the studies was tested using χ² test and I² statistic. If a significant heterogeneity (the χ² square test P < 0.10) was found, the random-effect model was used in the analysis, and if the heterogeneity was not significant (χ² test, P ≥ 0.10), the fixed-effect model was used. Studies with substantial heterogeneity (I² ≥ 50%) are not suitable for meta-analysis.

Figure 4.. Baseline Factors of Gender, Genotype (HCV) and Fibrosis Level and HCC Risk

The heterogeneity of the studies was tested using χ² test and I² statistic. If significant heterogeneity (χ² test, P < 0.10) was found, the random-effect model was used in the analysis, and if the heterogeneity was not significant (χ² test, P ≥ 0.10), the fixed-effect model was used. Studies with substantial heterogeneity (I² ≥ 50%) are not suitable for meta-analysis.