Objective: To compare the efficacy of generic direct-acting agents and brand-name medicines for treating hepatitis C virus (HCV) infection by conducting a systematic review and meta-analysis. Methods: We searched online databases for studies that reported sustained virological responses 12 weeks after the end of HCV treatment with generic direct-acting agents. We derived pooled proportions of treated patients with a sustained virological response from intentionto-treat and per-protocol analyses. In addition, we calculated the pooled relative risk (RR) of a sustained virological response brand-name versus generic direct-acting agents using a random-effects model (DerSimonian–Laird) from the data available. Between-study heterogeneity was assessed using the I 2 statistic. Findings: We identified 19 studies involving a total of 57 433 individuals from eight territories or regions. The pooled overall proportions of patients with a sustained virological response were 98% (95% confidence interval, CI: 97–99; 18 studies; I 2=94.1%) in per-protocol analyses and 96% (95% CI: 93–98; 8 studies; I 2=68.1%) in intention-to-treat analyses. The likelihood of a sustained virological response with brandname medicines was similar to that with generic direct-acting agents (RR: 1.00; 95% CI: 0.98–1.02; I 2=0.0%). The likelihood of a sustained virological response was significantly higher in patients without than with cirrhosis (RR:1.03; 95% CI: 1.01–1.06; 7 studies) but was not significantly affected by either previous treatment (3 studies) or human immunodeficiency virus coinfection (3 studies). Conclusion: Generic direct-acting agents are highly effective for treating hepatitis C. Generic agents should be considered in resourceconstrained settings for decreasing the burden of liver disease in HCV-infected patients.

Comparar la eficacia de los antivirales genéricos de acción directa y los medicamentos de marca para el tratamiento de la infección por el virus de la hepatitis C (VHC) mediante la realización de una revisión sistemática y un metaanálisis.

Comparer l’efficacité des antiviraux à action directe génériques et des médicaments de marque pour traiter l'infection par le virus de l’hépatite C (VHC) à l’aide d’une revue systématique et d’une méta-analyse.