Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts

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dc.contributor.authorDavies, Annaen_ZA
dc.contributor.authorSingh, Kasha Pen_ZA
dc.contributor.authorShubber, Zaraen_ZA
dc.contributor.authorduCros, Philippen_ZA
dc.contributor.authorMills, Edward Jen_ZA
dc.contributor.authorCooke, Grahamen_ZA
dc.contributor.authorFord, Nathanen_ZA
dc.date.accessioned2015-11-16T04:09:41Z
dc.date.available2015-11-16T04:09:41Z
dc.date.issued2013en_ZA
dc.description.abstractIntroduction Co-infection with Hepatitis C (HCV) and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor. METHODS: We conducted a systematic review and meta-analysis to assess HCV treatment outcomes in observational cohorts. Two databases (Medline and EMBASE) were searched using a compound search strategy for cohort studies reporting HCV treatment outcomes (as determined by a sustained virological response, SVR) in HIV-positive patients initiating HCV treatment for the first time. RESULTS: 40 studies were included for review, providing outcomes on 5339 patients from 17 countries. The pooled proportion of patients achieving SVR was 38%. Significantly poorer outcomes were observed for patients infected with HCV genotypes 1 or 4 (pooled SVR 24.5%), compared to genotypes 2 or 3 (pooled SVR 59.8%). The pooled proportion of patients who discontinued treatment due to drug toxicities (reported by 33 studies) was low, at 4.3% (3.3-5.3%). Defaulting from treatment, reported by 33 studies, was also low (5.1%, 3.5-6.6%), as was on-treatment mortality (35 studies, 0.1% (0-0.2%)). CONCLUSIONS: These results, reported under programmatic conditions, are comparable to those reported in randomised clinical trials, and show that although HCV treatment outcomes are generally poor in HIV co-infected patients, those infected with HCV genotypes 2 or 3 have outcomes comparable to HIV-negative patients.en_ZA
dc.identifier.apacitationDavies, A., Singh, K. P., Shubber, Z., duCros, P., Mills, E. J., Cooke, G., & Ford, N. (2013). Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts. <i>PLoS One</i>, http://hdl.handle.net/11427/15005en_ZA
dc.identifier.chicagocitationDavies, Anna, Kasha P Singh, Zara Shubber, Philipp duCros, Edward J Mills, Graham Cooke, and Nathan Ford "Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15005en_ZA
dc.identifier.citationDavies, A., Singh, K. P., Shubber, Z., Ducros, P., Mills, E. J., Cooke, G., & Ford, N. (2013). Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts. PloS one, 8(2), e55373. doi:10.1371/journal.pone.0055373en_ZA
dc.identifier.ris TY - Journal Article AU - Davies, Anna AU - Singh, Kasha P AU - Shubber, Zara AU - duCros, Philipp AU - Mills, Edward J AU - Cooke, Graham AU - Ford, Nathan AB - Introduction Co-infection with Hepatitis C (HCV) and HIV is common and HIV accelerates hepatic disease progression due to HCV. However, access to HCV treatment is limited and success rates are generally poor. METHODS: We conducted a systematic review and meta-analysis to assess HCV treatment outcomes in observational cohorts. Two databases (Medline and EMBASE) were searched using a compound search strategy for cohort studies reporting HCV treatment outcomes (as determined by a sustained virological response, SVR) in HIV-positive patients initiating HCV treatment for the first time. RESULTS: 40 studies were included for review, providing outcomes on 5339 patients from 17 countries. The pooled proportion of patients achieving SVR was 38%. Significantly poorer outcomes were observed for patients infected with HCV genotypes 1 or 4 (pooled SVR 24.5%), compared to genotypes 2 or 3 (pooled SVR 59.8%). The pooled proportion of patients who discontinued treatment due to drug toxicities (reported by 33 studies) was low, at 4.3% (3.3-5.3%). Defaulting from treatment, reported by 33 studies, was also low (5.1%, 3.5-6.6%), as was on-treatment mortality (35 studies, 0.1% (0-0.2%)). CONCLUSIONS: These results, reported under programmatic conditions, are comparable to those reported in randomised clinical trials, and show that although HCV treatment outcomes are generally poor in HIV co-infected patients, those infected with HCV genotypes 2 or 3 have outcomes comparable to HIV-negative patients. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0055373 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts TI - Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts UR - http://hdl.handle.net/11427/15005 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15005
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0055373
dc.identifier.vancouvercitationDavies A, Singh KP, Shubber Z, duCros P, Mills EJ, Cooke G, et al. Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts. PLoS One. 2013; http://hdl.handle.net/11427/15005.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Davies et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHepatitis C virusen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherDrug therapyen_ZA
dc.subject.otherInterferonsen_ZA
dc.subject.otherHighly-active antiretroviral therapyen_ZA
dc.titleTreatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohortsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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