Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
<h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies ap...
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0090611&type=printable |
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| author | Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu |
| author_facet | Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu |
| author_sort | Fang Wei |
| collection | DOAJ |
| description | <h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies appear to have limited efficacy and their use remains controversial. The present study aimed to evaluate the efficacy and safety of IFN-based therapies for HCV infection post RT.<h4>Methods</h4>We searched Pubmed, Embase, Web of Knowledge, and The Cochrane Library (1997-2013) for clinical trials in which transplant patients were given Interferon (IFN), pegylated interferon (PEG), interferon plus ribavirin (IFN-RIB), or pegylated interferon plus ribavirin (PEG-RIB). The Sustained Virological Response (SVR) and/or drop-out rates were the primary outcomes. Summary estimates were calculated using the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analysis.<h4>Results</h4>We identified 12 clinical trials (140 patients in total). The summary estimate for SVR rate, drop-out rate and graft rejection rate was 26.6% (95%CI, 15.0-38.1%), 21.1% (95% CI, 10.9-31.2%) and 4% (95%CI: 0.8%-7.1%), respectively. The overall SVR rate in PEG-based and standard IFN-based therapy was 40.6% (24/59) and 20.9% (17/81), respectively. The most frequent side-effect requiring discontinuation of treatment was graft dysfunction (14 cases, 45.1%). Meta-regression analysis showed the covariates included contribute to the heterogeneity in the SVR logit rate, but not in the drop-out logit rate. The sensitivity analyses by the random model yielded very similar results to the fixed-effects model.<h4>Conclusions</h4>IFN-based therapy for HCV infection post RT has poor efficacy and limited safety. PEG-based therapy is a more effective approach for treating HCV infection post-RT than standard IFN-based therapy. Future research is required to develop novel strategies to improve therapeutic efficacy and tolerability, and reduce the liver-related morbidity and mortality in this important patient population. |
| format | Article |
| id | doaj-art-5f797e27dbda45cfa5f7f70aad8dec00 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-5f797e27dbda45cfa5f7f70aad8dec002025-08-20T03:00:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9061110.1371/journal.pone.0090611Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.Fang WeiJunying LiuFen LiuHuaidong HuHong RenPeng Hu<h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies appear to have limited efficacy and their use remains controversial. The present study aimed to evaluate the efficacy and safety of IFN-based therapies for HCV infection post RT.<h4>Methods</h4>We searched Pubmed, Embase, Web of Knowledge, and The Cochrane Library (1997-2013) for clinical trials in which transplant patients were given Interferon (IFN), pegylated interferon (PEG), interferon plus ribavirin (IFN-RIB), or pegylated interferon plus ribavirin (PEG-RIB). The Sustained Virological Response (SVR) and/or drop-out rates were the primary outcomes. Summary estimates were calculated using the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analysis.<h4>Results</h4>We identified 12 clinical trials (140 patients in total). The summary estimate for SVR rate, drop-out rate and graft rejection rate was 26.6% (95%CI, 15.0-38.1%), 21.1% (95% CI, 10.9-31.2%) and 4% (95%CI: 0.8%-7.1%), respectively. The overall SVR rate in PEG-based and standard IFN-based therapy was 40.6% (24/59) and 20.9% (17/81), respectively. The most frequent side-effect requiring discontinuation of treatment was graft dysfunction (14 cases, 45.1%). Meta-regression analysis showed the covariates included contribute to the heterogeneity in the SVR logit rate, but not in the drop-out logit rate. The sensitivity analyses by the random model yielded very similar results to the fixed-effects model.<h4>Conclusions</h4>IFN-based therapy for HCV infection post RT has poor efficacy and limited safety. PEG-based therapy is a more effective approach for treating HCV infection post-RT than standard IFN-based therapy. Future research is required to develop novel strategies to improve therapeutic efficacy and tolerability, and reduce the liver-related morbidity and mortality in this important patient population.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0090611&type=printable |
| spellingShingle | Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. PLoS ONE |
| title | Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. |
| title_full | Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. |
| title_fullStr | Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. |
| title_full_unstemmed | Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. |
| title_short | Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis. |
| title_sort | interferon based anti viral therapy for hepatitis c virus infection after renal transplantation an updated meta analysis |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0090611&type=printable |
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