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Efficacy and safety of sofosbuvir/velpatasvir with or without ribavirin in hepatitis C genotype 3 compensated cirrhosis:A meta-analysis

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World Journal of Hepatology 2022年第6期14卷 1248-1257页

作者： Jing Hong Loo Wen Xin Flora Xu Jun Teck Low Wei Xuan Tay le shaun ang Yew Chong Tam Prem Harichander Thurairajah Rahul Kumar Yu Jun Wong Yong Loo Lin School of Medicine National University of SingaporeSingapore 119077Singapore Education Resource Center Medical BoardSingapore General HospitalSingapore 100059Singapore Department of Gastroenterology and Hepatology National University HospitalSingapore 119077Singapore Department of Gastroenterology and Hepatology Changi General HospitalSingapore 529889Singapore Duke-NUS Medicine Academic Clinical Program Singapore 100059Singapore

BACKGROUND Hepatitis C virus(HCV)is a leading cause of liver cirrhosis and hepatocellular carcinoma ***/velpatasvir(SOF/VEL)is an effective pangenotypic direct-acting antiviral combination for treatment of chronic HCV *** the addition of ribavirin(RBV)to SOF/VEL improved sustained virological response(SVR12)in genotype 3(GT3)decompensated cirrhosis patients,the benefits of RBV in GT3 compensated cirrhosis patients receiving SOF/VEL remains *** To evaluate the efficacy and safety of SOF/VEL,with or without RBV in GT3 compensated cirrhosis *** We searched four electronic databases(PubMed/Medline,Embase,Cochrane Library and Web of Science)from inception up to June 2021 using both free text and MeSH *** was no restriction on language,geography,publication dates and publication status(full text or abstracts).All GT3 compensated cirrhosis patients treated with 12 wk of SOF/VEL,with or without RBV,were included,regardless of age,gender or prior treatment *** primary outcome was sustained virological response 12-wk posttreatment(SVR12).The secondary outcome was treatment-related adverse events,as defined by symptomatic anemia requiring transfusion or a drop in hemoglobin beyond 2 g/*** pooled relative risk(RR),95%CI and heterogeneity(I^(2))were estimated using Review Manager version *** From 1752 citations,a total of seven studies(2 randomized controlled trials,5 cohort studies)with 1088 subjects were *** SVR12 was similar in GT3 compensated cirrhosis patients,regardless of the use of RBV,for both the intention-to-treat RR 1.03,95%CI:0.99-1.07;I^(2)=0%)and the per-protocol analysis(RR:1.03,95%CI:0.99-1.07;I^(2)=48%).The overall pooled rate of treatment-related adverse events was 7.2%.Addition of RBV increased the pooled risk of treatment-related adverse events in GT3 compensated cirrhosis patients receiving SOF/VEL(RR:4.20,95%CI:1.29-13.68;I^(2)=0%).Subgroup analysis showed that RBV wa

关键词： Direct-acting antiviral Hepatitis C Cirrhosis Sofosbuvir/velpatasvir

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