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Meta-Analysis
. 2021 Feb 10;16(2):e0246594.
doi: 10.1371/journal.pone.0246594. eCollection 2021.

An updated systematic review and meta-analysis on efficacy of Sofosbuvir in treating hepatitis C-infected patients with advanced chronic kidney disease

Sara Majd Jabbari  1 , Khadije Maajani  2 , Shahin Merat  3 , Hossein Poustchi  3 , Sadaf G Sepanlou  1
Affiliations
Meta-Analysis

An updated systematic review and meta-analysis on efficacy of Sofosbuvir in treating hepatitis C-infected patients with advanced chronic kidney disease

Sara Majd Jabbari et al. PLoS One. .

Abstract

Sofosbuvir seems to be a revolutionary treatment for Hepatitis C-infected patients with advanced chronic kidney disease (CKD) but existing evidence is not quite adequate. The aim of this study was to evaluate the efficacy and safety of Sofosbuvir-based therapy without Ribavirin for all hepatitis C virus genotypes among patients with advanced CKD. We conducted an updated systematic literature search from the beginning of 2013 up to June 2020. Sustained virologic response (SVR) rate at 12 and/or 24 weeks after the end of treatment, and adverse events in HCV-infected patients with advanced CKD were pooled using random effects models. We included 27 published articles in our meta-analyses, totaling 1,464 HCV-infected patients with advanced CKD. We found a substantial heterogeneity based on the I2 index (P = 0.00, I2 = 56.1%). The pooled SVR rates at 12 and 24 weeks after the end of Sofosbuvir-based treatment were 97% (95% Confidence Interval: 95-99) and 95% (89-99) respectively. The pooled SVR12 rates were 98% (96-100) and 94% (90-97) in patients under 60 and over 60 years old respectively. The pooled incidence of severe adverse events was 0.11 (0.04-0.19). The pooled SVR12 rate after completion of the half dose regimen was as high as the full dose treatment but it was associated with less adverse events (0.06 versus 0.14). The pooled SVR12 rate was 98% (91-100) in cirrhotic patients and 100% (98-100) in non-cirrhotic patients. The endorsement of Sofosbuvir-based regimen can improve the treatment of hepatitis C virus infection in patients with advanced CKD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart showing different phases of selecting relevant publications.
Fig 2
Fig 2. Forest plot of the pooled SVR12 rate in HCV-infected patients with advanced chronic kidney disease.
Fig 3
Fig 3. Forest plot of the pooled SVR12 rate in HCV-infected patients with advanced CKD sub-grouped based on diagnosis of cirrhosis.
Fig 4
Fig 4. Forest plot of the pooled SVR12 rate in HCV-infected patient with advanced CKD sub-grouped by SOF-based regimen dose.
Fig 5
Fig 5. Forest plot of the pooled SVR12 rate in HCV-infected patients with advanced CKD sub-grouped based on the use of SOF-based regimen with or without RBV.
(1): SOF+DCV; (2): SOF+LDV; (3): SOF+SMV; (4): SOF+RBV; (5): SOF+DCV+RBV; (6): SOF+PEG+RBV.DCV = Daclatasvir. LDV = Ledipasvir. SMV = Simeprevir. RBV = Ribavirin.
Fig 6
Fig 6. Forest plot of the pooled SVR12 rate in HCV-infected patients with advanced CKD by treatment strategy.
DCV = Daclatasvir. LDV = Ledipasvir. SMV = Simeprevir. RBV = Ribavirin.
See this image and copyright information in PMC

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