Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.

<h4>Introduction</h4>Co-infection with Hepatitis C (HCV) and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor.<h4>Methods</h4>We conducted a systematic review and meta-an...

Full description

Saved in:
Bibliographic Details
Main Authors: Anna Davies, Kasha P Singh, Zara Shubber, Philipp Ducros, Edward J Mills, Graham Cooke, Nathan Ford
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0055373
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850116133594595328
author Anna Davies
Kasha P Singh
Zara Shubber
Philipp Ducros
Edward J Mills
Graham Cooke
Nathan Ford
author_facet Anna Davies
Kasha P Singh
Zara Shubber
Philipp Ducros
Edward J Mills
Graham Cooke
Nathan Ford
author_sort Anna Davies
collection DOAJ
description <h4>Introduction</h4>Co-infection with Hepatitis C (HCV) and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor.<h4>Methods</h4>We conducted a systematic review and meta-analysis to assess HCV treatment outcomes in observational cohorts. Two databases (Medline and EMBASE) were searched using a compound search strategy for cohort studies reporting HCV treatment outcomes (as determined by a sustained virological response, SVR) in HIV-positive patients initiating HCV treatment for the first time.<h4>Results</h4>40 studies were included for review, providing outcomes on 5339 patients from 17 countries. The pooled proportion of patients achieving SVR was 38%. Significantly poorer outcomes were observed for patients infected with HCV genotypes 1 or 4 (pooled SVR 24.5%), compared to genotypes 2 or 3 (pooled SVR 59.8%). The pooled proportion of patients who discontinued treatment due to drug toxicities (reported by 33 studies) was low, at 4.3% (3.3-5.3%). Defaulting from treatment, reported by 33 studies, was also low (5.1%, 3.5-6.6%), as was on-treatment mortality (35 studies, 0.1% (0-0.2%)).<h4>Conclusions</h4>These results, reported under programmatic conditions, are comparable to those reported in randomised clinical trials, and show that although HCV treatment outcomes are generally poor in HIV co-infected patients, those infected with HCV genotypes 2 or 3 have outcomes comparable to HIV-negative patients.
format Article
id doaj-art-2cd55d9b479e41598fc221fcf9758983
institution OA Journals
issn 1932-6203
language English
publishDate 2013-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-2cd55d9b479e41598fc221fcf97589832025-08-20T02:36:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0182e5537310.1371/journal.pone.0055373Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.Anna DaviesKasha P SinghZara ShubberPhilipp DucrosEdward J MillsGraham CookeNathan Ford<h4>Introduction</h4>Co-infection with Hepatitis C (HCV) and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor.<h4>Methods</h4>We conducted a systematic review and meta-analysis to assess HCV treatment outcomes in observational cohorts. Two databases (Medline and EMBASE) were searched using a compound search strategy for cohort studies reporting HCV treatment outcomes (as determined by a sustained virological response, SVR) in HIV-positive patients initiating HCV treatment for the first time.<h4>Results</h4>40 studies were included for review, providing outcomes on 5339 patients from 17 countries. The pooled proportion of patients achieving SVR was 38%. Significantly poorer outcomes were observed for patients infected with HCV genotypes 1 or 4 (pooled SVR 24.5%), compared to genotypes 2 or 3 (pooled SVR 59.8%). The pooled proportion of patients who discontinued treatment due to drug toxicities (reported by 33 studies) was low, at 4.3% (3.3-5.3%). Defaulting from treatment, reported by 33 studies, was also low (5.1%, 3.5-6.6%), as was on-treatment mortality (35 studies, 0.1% (0-0.2%)).<h4>Conclusions</h4>These results, reported under programmatic conditions, are comparable to those reported in randomised clinical trials, and show that although HCV treatment outcomes are generally poor in HIV co-infected patients, those infected with HCV genotypes 2 or 3 have outcomes comparable to HIV-negative patients.https://doi.org/10.1371/journal.pone.0055373
spellingShingle Anna Davies
Kasha P Singh
Zara Shubber
Philipp Ducros
Edward J Mills
Graham Cooke
Nathan Ford
Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
PLoS ONE
title Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
title_full Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
title_fullStr Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
title_full_unstemmed Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
title_short Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.
title_sort treatment outcomes of treatment naive hepatitis c patients co infected with hiv a systematic review and meta analysis of observational cohorts
url https://doi.org/10.1371/journal.pone.0055373
work_keys_str_mv AT annadavies treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT kashapsingh treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT zarashubber treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT philippducros treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT edwardjmills treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT grahamcooke treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts
AT nathanford treatmentoutcomesoftreatmentnaivehepatitiscpatientscoinfectedwithhivasystematicreviewandmetaanalysisofobservationalcohorts