Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.

<h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies ap...

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Autores principales:	Fang Wei, Junying Liu, Fen Liu, Huaidong Hu, Hong Ren, Peng Hu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5f797e27dbda45cfa5f7f70aad8dec00
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spelling	oai:doaj.org-article:5f797e27dbda45cfa5f7f70aad8dec002021-11-18T08:25:08ZInterferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.1932-620310.1371/journal.pone.0090611https://doaj.org/article/5f797e27dbda45cfa5f7f70aad8dec002014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24699257/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies appear to have limited efficacy and their use remains controversial. The present study aimed to evaluate the efficacy and safety of IFN-based therapies for HCV infection post RT.<h4>Methods</h4>We searched Pubmed, Embase, Web of Knowledge, and The Cochrane Library (1997-2013) for clinical trials in which transplant patients were given Interferon (IFN), pegylated interferon (PEG), interferon plus ribavirin (IFN-RIB), or pegylated interferon plus ribavirin (PEG-RIB). The Sustained Virological Response (SVR) and/or drop-out rates were the primary outcomes. Summary estimates were calculated using the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analysis.<h4>Results</h4>We identified 12 clinical trials (140 patients in total). The summary estimate for SVR rate, drop-out rate and graft rejection rate was 26.6% (95%CI, 15.0-38.1%), 21.1% (95% CI, 10.9-31.2%) and 4% (95%CI: 0.8%-7.1%), respectively. The overall SVR rate in PEG-based and standard IFN-based therapy was 40.6% (24/59) and 20.9% (17/81), respectively. The most frequent side-effect requiring discontinuation of treatment was graft dysfunction (14 cases, 45.1%). Meta-regression analysis showed the covariates included contribute to the heterogeneity in the SVR logit rate, but not in the drop-out logit rate. The sensitivity analyses by the random model yielded very similar results to the fixed-effects model.<h4>Conclusions</h4>IFN-based therapy for HCV infection post RT has poor efficacy and limited safety. PEG-based therapy is a more effective approach for treating HCV infection post-RT than standard IFN-based therapy. Future research is required to develop novel strategies to improve therapeutic efficacy and tolerability, and reduce the liver-related morbidity and mortality in this important patient population.Fang WeiJunying LiuFen LiuHuaidong HuHong RenPeng HuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e90611 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
description	<h4>Background</h4>Hepatitis C virus (HCV) infection is highly prevalent in renal transplant (RT) recipients. Currently, interferon-based (IFN-based) antiviral therapies are the standard approach to control HCV infection. In a post-transplantation setting, however, IFN-based therapies appear to have limited efficacy and their use remains controversial. The present study aimed to evaluate the efficacy and safety of IFN-based therapies for HCV infection post RT.<h4>Methods</h4>We searched Pubmed, Embase, Web of Knowledge, and The Cochrane Library (1997-2013) for clinical trials in which transplant patients were given Interferon (IFN), pegylated interferon (PEG), interferon plus ribavirin (IFN-RIB), or pegylated interferon plus ribavirin (PEG-RIB). The Sustained Virological Response (SVR) and/or drop-out rates were the primary outcomes. Summary estimates were calculated using the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analysis.<h4>Results</h4>We identified 12 clinical trials (140 patients in total). The summary estimate for SVR rate, drop-out rate and graft rejection rate was 26.6% (95%CI, 15.0-38.1%), 21.1% (95% CI, 10.9-31.2%) and 4% (95%CI: 0.8%-7.1%), respectively. The overall SVR rate in PEG-based and standard IFN-based therapy was 40.6% (24/59) and 20.9% (17/81), respectively. The most frequent side-effect requiring discontinuation of treatment was graft dysfunction (14 cases, 45.1%). Meta-regression analysis showed the covariates included contribute to the heterogeneity in the SVR logit rate, but not in the drop-out logit rate. The sensitivity analyses by the random model yielded very similar results to the fixed-effects model.<h4>Conclusions</h4>IFN-based therapy for HCV infection post RT has poor efficacy and limited safety. PEG-based therapy is a more effective approach for treating HCV infection post-RT than standard IFN-based therapy. Future research is required to develop novel strategies to improve therapeutic efficacy and tolerability, and reduce the liver-related morbidity and mortality in this important patient population.
format	article
author	Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu
author_facet	Fang Wei Junying Liu Fen Liu Huaidong Hu Hong Ren Peng Hu
author_sort	Fang Wei
title	Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
title_short	Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
title_full	Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
title_fullStr	Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
title_full_unstemmed	Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.
title_sort	interferon-based anti-viral therapy for hepatitis c virus infection after renal transplantation: an updated meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/5f797e27dbda45cfa5f7f70aad8dec00
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Interferon-based anti-viral therapy for hepatitis C virus infection after renal transplantation: an updated meta-analysis.

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