Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Sep;35(9):1477-1487.
doi: 10.1111/jgh.15051. Epub 2020 Apr 15.

Efficacy and safety of direct acting antiviral regimens for hepatitis C virus and human immunodeficiency virus co-infection: systematic review and network meta-analysis

Yi-Xiang Zheng  1 , Shu-Juan Ma  2 , Ying-Hui Xiong  1 , Xue-Gong Fan  1
Affiliations
Meta-Analysis

Efficacy and safety of direct acting antiviral regimens for hepatitis C virus and human immunodeficiency virus co-infection: systematic review and network meta-analysis

Yi-Xiang Zheng et al. J Gastroenterol Hepatol. 2020 Sep.

Abstract

Background and aim: Various all-oral direct-acting antiviral (DAA) regimens are being widely used in the treatment of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients; however, the comparative efficacy and safety of different types and combinations of DAAs are not completely clear. There is still a lack of integration of evidence for optimized therapies for HIV/HCV co-infection.

Methods: We conducted a systematic literature search in several databases up to January 1, 2020. All the studies that reported the sustained virologic response (SVR) and adverse events of DAAs in HIV/HCV co-infected patients were included. The Bayesian Markov Chain Monte Carlo method was used for the pooled estimates of network meta-analysis.

Results: We identified 33 eligible articles with 7 combinations of all-oral DAAs for the analyses of efficacy and safety. Grazoprevir-elbasvir ± ribavirin (GZR/EBR ± RBV: 95.6%; 95% CrI, 91.7-98.1%), ombitasvir/paritaprevir/ritonavir and dasabuvir ± ribavirin (3D ± RBV: 95.3%; 95% CrI, 93.4-96.9%), sofosbuvir-ledipasvir ± ribavirin (SOF/LDV ± RBV: 95.2%; 95% CrI, 93.7-96.6%), and sofosbuvir-daclatasvir ± ribavirin (SOF/DCV ± RBV: 94.8%; 95% CrI, 92.5-96.6%) were the most effective combinations for HIV/HCV co-infected patients, with SVR rates of approximately 94% and above while severe adverse events were rare. However, the SVR rates of sofosbuvir-ribavirin (SOF/RBV) and sofosbuvir-simeprevir ± ribavirin (SOF/SMV ± RBV) both failed to reach 90%, and the incidences of adverse events were higher than 5%.

Conclusions: Efficacy and safety of all-oral DAAs were in prospect for HIV/HCV co-infection patients. GZR/EBR ± RBV was the optimal combination recommended for HIV/HCV co-infected patients based on the excellent treatment effects and insignificant adverse events.

Keywords: Direct-acting antivirals; Hepatitis C virus; Human immunodeficiency virus; Safety; Sustained virologic response.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Messina JP, Humphreys I, Flaxman A et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology (Baltimore, Md) 2015; 61: 77-87.
    1. Bonora S, Puoti M. Use of daclatasvir in HCV/HIV-coinfected patients in a real-life setting. AIDS Rev. 2017; 19: 24-34.
    1. Thomson EC, Fleming VM, Main J et al. Predicting spontaneous clearance of acute hepatitis C virus in a large cohort of HIV-1-infected men. Gut 2011; 60: 837-845.
    1. Kirk GD, Mehta SH, Astemborski J et al. HIV, age, and the severity of hepatitis C virus-related liver disease: a cohort study. Ann. Intern. Med. 2013; 158: 658-666.
    1. Naggie S, Muir AJ. Oral combination therapies for hepatitis C virus infection: successes, challenges, and unmet needs. Annu. Rev. Med. 2017; 68: 345-358.

MeSH terms

LinkOut - more resources