Kronik HCV infeksiyonunda tedavi yanıtının uzun süreli mortalite riski üzerine etkisi Simmons ve arkadaşlarının sistemik derlemesi ve metaanalizinde irdelenmiş
Simmons B, Saleem J, Heath K, Cooke GS, Hill A.Clin Infect Dis. 2015 May 17. pii: civ396.
Long-term treatment outcomes of patients infected with Hepatitis C virus: a systematic review and meta-analysis of the survival benefit of achieving a Sustained Virological Response.
Achievement of a sustained virologic response (SVR) after treatment for Hepatitis C infection is associated with improved outcomes. This meta-analysis aimed to determine the impact of SVR on long-term mortality risk compared with non-responders in a range of populations.
An electronic search identified all studies assessing all-cause mortality in SVR and non-SVR patients. Eligible articles were stratified into general, cirrhotic, and HIV co-infected populations. The adjusted hazard ratio (95%CI) for mortality in patients achieving SVR versus non-SVR, and pooled estimates for the five-year mortality in each group were calculated.
31 studies (n=33,360) were identified as suitable for inclusion. Median follow-up time was 5.4 years (IQR 4.9-7.5) across all studies. The adjusted hazard ratio of mortality for patients achieving SVR versus non-SVR was 0.50 (95%CI 0.37-0.67) in the general population, 0.26 (95%CI 0.18-0.74) in the cirrhotic group, and 0.21 (0.10-0.45) in the co-infected group. The pooled five-year mortality rates were significantly lower for patients achieving SVR compared with non-SVR in all three populations.
The results suggest that there is a significant survival benefit of achieving an SVR compared with unsuccessful treatment in a range of HCV-infected populations.