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

Authors :
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
Source :
World Journal of Hepatology. 14:1248-1257
Publication Year :
2022
Publisher :
Baishideng Publishing Group Inc., 2022.

Abstract

Hepatitis C virus (HCV) is a leading cause of liver cirrhosis and hepatocellular carcinoma globally. Sofosbuvir/velpatasvir (SOF/VEL) is an effective pan-genotypic direct-acting antiviral combination for treatment of chronic HCV infection. While 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 unclear.To evaluate the efficacy and safety of SOF/VEL, with or without RBV in GT3 compensated cirrhosis patients.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 terms. There 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 experience. The primary outcome was sustained virological response 12-wk post-treatment (SVR12). The secondary outcome was treatment-related adverse events, as defined by symptomatic anemia requiring transfusion or a drop in hemoglobin beyond 2 g/dL. The pooled relative risk (RR), 95%CI and heterogeneity (From 1752 citations, a total of seven studies (2 randomized controlled trials, 5 cohort studies) with 1088 subjects were identified. The 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;Ribavirin was not associated with higher SVR12 in GT3 compensated cirrhosis patients receiving SOF/VEL. Our findings suggest a limited role for RBV as routine add-on therapy to SOF/VEL in GT3 compensated cirrhosis patients.

Subjects

Subjects :
Hepatology

Details

ISSN :
19485182
Volume :
14
Database :
OpenAIRE
Journal :
World Journal of Hepatology
Accession number :
edsair.doi.dedup.....aafaa1df0f1d040f244affa965786d53