Efficacy and safety of direct acting antiviral regimens for hepatitis C virus and human immunodeficiency virus co-infection: systematic review and network meta-analysis
| Autor: | Ying‐hui Xiong, Xue-Gong Fan, Yixiang Zheng, Shujuan Ma |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Cyclopropanes Male medicine.medical_specialty Sustained Virologic Response Hepatitis C virus Administration Oral HIV Infections medicine.disease_cause Gastroenterology Antiviral Agents chemistry.chemical_compound Internal medicine Quinoxalines Ribavirin medicine Humans Adverse effect Aged Benzofurans Sulfonamides Dasabuvir Hepatology business.industry Coinfection Imidazoles virus diseases Hepatitis C Chronic Middle Aged Amides digestive system diseases Ombitasvir Treatment Outcome chemistry Paritaprevir Meta-analysis Ritonavir Drug Therapy Combination Female Carbamates Safety business medicine.drug |
| Zdroj: | Journal of gastroenterology and hepatologyReferences. 35(9) |
| ISSN: | 1440-1746 |
| Popis: | Background and aim Various all-oral direct-acting antiviral (DAA) regimens are being widely used in the treatment of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients; however, the comparative efficacy and safety of different types and combinations of DAAs are not completely clear. There is still a lack of integration of evidence for optimized therapies for HIV/HCV co-infection. Methods We conducted a systematic literature search in several databases up to January 1, 2020. All the studies that reported the sustained virologic response (SVR) and adverse events of DAAs in HIV/HCV co-infected patients were included. The Bayesian Markov Chain Monte Carlo method was used for the pooled estimates of network meta-analysis. Results We identified 33 eligible articles with 7 combinations of all-oral DAAs for the analyses of efficacy and safety. Grazoprevir-elbasvir ± ribavirin (GZR/EBR ± RBV: 95.6%; 95% CrI, 91.7-98.1%), ombitasvir/paritaprevir/ritonavir and dasabuvir ± ribavirin (3D ± RBV: 95.3%; 95% CrI, 93.4-96.9%), sofosbuvir-ledipasvir ± ribavirin (SOF/LDV ± RBV: 95.2%; 95% CrI, 93.7-96.6%), and sofosbuvir-daclatasvir ± ribavirin (SOF/DCV ± RBV: 94.8%; 95% CrI, 92.5-96.6%) were the most effective combinations for HIV/HCV co-infected patients, with SVR rates of approximately 94% and above while severe adverse events were rare. However, the SVR rates of sofosbuvir-ribavirin (SOF/RBV) and sofosbuvir-simeprevir ± ribavirin (SOF/SMV ± RBV) both failed to reach 90%, and the incidences of adverse events were higher than 5%. Conclusions Efficacy and safety of all-oral DAAs were in prospect for HIV/HCV co-infection patients. GZR/EBR ± RBV was the optimal combination recommended for HIV/HCV co-infected patients based on the excellent treatment effects and insignificant adverse events. |
| Databáze: | OpenAIRE |
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