Chronic hepatitis C treatment outcomes in low- and middle-income countries: a systematic review and meta-analysis.

Abstract:

OBJECTIVE:To assess the effectiveness of treatment for hepatitis C virus (HCV) infection in low- and middle-income countries and identify factors associated with successful outcomes. METHODS:We performed a systematic review and meta-analysis of studies of HCV treatment programmes in low- and middle-income countries. The primary outcome was a sustained virological response (SVR). Factors associated with treatment outcomes were identified by random-effects meta-regression analysis. FINDINGS:The analysis involved data on 12 213 patients included in 93 studies from 17 countries. The overall SVR rate was 52% (95% confidence interval, CI: 48-56). For studies in which patients were predominantly infected with genotype 1 or 4 HCV, the pooled SVR rate was 49% (95% CI: 43-55). This was significantly lower than the rate of 59% (95% CI: 54-64) found in studies in which patients were predominantly infected with other genotypes (P = 0.012). Factors associated with successful outcomes included treatment with pegylated interferon and ribavirin, infection with an HCV genotype other than genotype 1 or 4 and the absence of liver damage or human immunodeficiency virus infection at baseline. No significant difference in the SVR rate was observed between weight-adjusted and fixed-dose ribavirin treatment. Overall, 17% (95% CI: 13-23) of adverse events resulted in treatment interruption or dose modification, but only 4% (95% CI: 3-5) resulted in treatment discontinuation. CONCLUSION:The outcomes of treatment for HCV infection in low- and middle-income countries were similar to those reported in high-income countries.

authors

Ford N,Kirby C,Singh K,Mills EJ,Cooke G,Kamarulzaman A,duCros P

doi

10.2471/BLT.11.097147

subject

Has Abstract

pub_date

2012-07-01 00:00:00

pages

540-50

issue

7

eissn

0042-9686

issn

1564-0604

pii

BLT.11.097147

journal_volume

90

pub_type

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