Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients: Meta-analysis of clinical studies

F. Fabrizi, V. Dixit, P. Messa, P. Martin

Research output: Contribution to journalArticle

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Abstract

Information on the antiviral treatment (pegylated interferon plus ribavirin) of chronic infection by hepatitis C virus (HCV) in patients on long-term dialysis is extremely limited. We evaluated the efficacy and safety of combination antiviral therapy (pegylated interferon plus ribavirin) in patients on long-term dialysis with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical studies. The primary outcome was sustained virological response (SVR) (as a measure of efficacy); the secondary outcome was dropout rate (as a measure of tolerability). We used the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. We identified eleven clinical studies (287 unique patients), two of them being controlled clinical trials. The summary estimate for SVR and dropout rate was 0.60 (95% Confidence Intervals, 0.47; 0.71) and 0.18 (95% CI, 0.08; 0.35), respectively; studies being heterogeneous with regard to both the outcomes. Stratified analysis reported a higher SVR rate in controlled trials, 0.86 (95% CI, 0.27; 0.99). The most common sources of dropout were anaemia (11/46 = 23%) and infections (6/46 = 13%). Meta-regression analysis showed a detrimental impact of HCV genotype 1 (P = 0.036) and dropout (P = 0.0001) rate upon the frequency of SVR. Antiviral therapy based on pegylated interferon plus ribavirin for HCV gives encouraging results in terms of efficacy and safety among patients on long-term dialysis; such approach should be considered the current standard of care for HCV-infected individuals on regular dialysis.

Original languageEnglish
Pages (from-to)681-689
Number of pages9
JournalJournal of Viral Hepatitis
Volume21
Issue number10
DOIs
Publication statusPublished - 2014

Fingerprint

Ribavirin
Hepatitis C
Hepacivirus
Interferons
Antiviral Agents
Meta-Analysis
Dialysis
Chronic Hepatitis C
Controlled Clinical Trials
Therapeutics
Standard of Care
Patient Safety
Infection
Anemia
Genotype
Regression Analysis
Confidence Intervals
Safety
Clinical Studies

Keywords

  • dialysis
  • hepatitis C virus
  • meta-analysis
  • pegylated interferon
  • ribavirin

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology
  • Medicine(all)

Cite this

Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients : Meta-analysis of clinical studies. / Fabrizi, F.; Dixit, V.; Messa, P.; Martin, P.

In: Journal of Viral Hepatitis, Vol. 21, No. 10, 2014, p. 681-689.

Research output: Contribution to journalArticle

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