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

Anna Davies, Kasha Singh, Zara Shubber, Philip duCros, Edward Mills, Graham Cooke, Nathan Ford

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Abstract

Introduction: 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. Methods: 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. Results: 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 )). Conclusions: 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. ? 2013 Davies et al.
Original languageEnglish
Article numbere55373
Number of pages10
JournalPLoS ONE
Volume8
Issue number2
DOIs
Publication statusPublished - 2013

Cite this

Davies, Anna ; Singh, Kasha ; Shubber, Zara ; duCros, Philip ; Mills, Edward ; Cooke, Graham ; Ford, Nathan. / Treatment outcomes of treatment-naive Hepatitis C patients co-infected with HIV: A systematic review and meta-analysis of observational cohorts. In: PLoS ONE. 2013 ; Vol. 8, No. 2.
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abstract = "Introduction: 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. Methods: 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. Results: 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 )). Conclusions: 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. ? 2013 Davies et al.",
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Treatment outcomes of treatment-naive Hepatitis C patients co-infected with HIV: A systematic review and meta-analysis of observational cohorts. / Davies, Anna; Singh, Kasha; Shubber, Zara; duCros, Philip; Mills, Edward; Cooke, Graham; Ford, Nathan.

In: PLoS ONE, Vol. 8, No. 2, e55373, 2013.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Treatment outcomes of treatment-naive Hepatitis C patients co-infected with HIV: A systematic review and meta-analysis of observational cohorts

AU - Davies, Anna

AU - Singh, Kasha

AU - Shubber, Zara

AU - duCros, Philip

AU - Mills, Edward

AU - Cooke, Graham

AU - Ford, Nathan

PY - 2013

Y1 - 2013

N2 - Introduction: 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. Methods: 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. Results: 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 )). Conclusions: 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. ? 2013 Davies et al.

AB - Introduction: 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. Methods: 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. Results: 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 )). Conclusions: 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. ? 2013 Davies et al.

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