| Author | Castro Filho, Elio C. | |
| Author | Piedade, Juliana | |
| Author | Castro, Rodolfo | |
| Author | Luz, Paula M. | |
| Author | Fernandes, Flavia | |
| Author | Grinsztejn, Beatriz | |
| Author | Veloso, Valdiléa G. | |
| Author | Pereira, Gustavo Henrique | |
| Author | Perazzo, Hugo | |
| Access date | 2021-01-11T12:09:20Z | |
| Available date | 2021-01-11T12:09:20Z | |
| Document date | 2020 | |
| Citation | CASTRO FILHO, Elio C. et al. Effectiveness of direct-acting agents for chronic hepatitis C treatment in South America: A systematic review and meta-analysis. Journal of Viral Hepatitis, v. 27, n. 12, p. 1396-1407, 2020. | |
| ISSN | 1352-0504 | |
| URI | https://www.arca.fiocruz.br/handle/icict/45554 | |
| Language | eng | en_US |
| Publisher | Wiley | |
| Rights | restricted access | |
| Title | Effectiveness of direct-acting agents for chronic hepatitis C treatment in South America: A systematic review and meta-analysis | en_US |
| Type | Preprint | |
| DOI | 10.1111/jvh.13364 | |
| Abstract | The effectiveness of direct-acting agents (DAAs) for hepatitis C treatment in limited-resource settings remains unclear. We estimated the pooled sustained virological response rates of DAA therapy in South America. We searched online databases for studies that reported 12-week sustained virological response (SVR12) to hepatitis C virus (HCV) treatment in individuals living in South America. Pooled SVR12 in intention-to-treat (ITT) and per-protocol were estimated. Additionally, using all studies with available data, the pooled relative risk (RR) of SVR12 using a random-effects model (DerSimonian-Laird) was estimated to compare effectiveness of DAAs in patients with or without cirrhosis, HIV co-infection or previous HCV therapy. Heterogeneity was assessed using the I2 statistics. We identified 20 studies [14 manuscripts and 6 conference abstracts] comprising 7393 individuals from five countries [Brazil (n = 11), Argentina (n = 4), Chile (n = 1), Colombia (n = 1) and Peru (n = 1)] and two South-American collaborations. The pooled overall SVR12 rates [95% confidence interval (CI)] were 92.6% [90.2-94.7] and 95.5% [94.3-96.6] by ITT (11 studies; n = 4,153; I2 = 84.2%) and per-protocol analysis (15 studies; n = 4,833; I2 = 64.5%), respectively. The RR of SVR12 was similar in patients with or without HIV co-infection [4 studies; RR = 1.03 (0.99-1.07)] and those naive compared with treatment experimented-individuals [9 studies; RR = 1.01 (1.00-1.03)], but significantly higher in patients without cirrhosis compared with those with cirrhosis [11 studies; RR = 1.04 (1.02-1.05), P < .001]. DAAs are highly effective for HCV treatment in South America. The use of DAAs should be considered in limited-resource settings to decrease the burden of liver disease in HCV-infected patients. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Hospital Federal de Bonsucesso. Departamento de Gastroenterologia & Hepatologia. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Instituto de Saúde Coletiva. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Hospital Federal de Bonsucesso. Departamento de Gastroenterologia & Hepatologia. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Hospital Federal de Bonsucesso. Departamento de Gastroenterologia & Hepatologia. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | |
| Subject | HCV therapy | en_US |
| Subject | South America | en_US |
| Subject | Hepatitis C | en_US |
| Subject | Interferon-free regimens | en_US |
