Matches in SemOpenAlex for { <https://semopenalex.org/work/W2945682340> ?p ?o ?g. }
- W2945682340 endingPage "485" @default.
- W2945682340 startingPage "473" @default.
- W2945682340 abstract "•The present study summarizes the SVR rate in patients with/without liver cancer treated with all oral DAAs. •The cure rate was lower in patients with liver cancer, especially those with active cancer. •Additional controlled studies are needed to study the impact of liver cancer on HCV cure rate in DAA-treated patients. Background & Aims The effect of hepatocellular carcinoma (HCC) on the response to interferon-free direct-acting antiviral (DAA) therapy in patients with chronic hepatitis C (CHC) infection remains unclear. Using a systematic review and meta-analysis approach, we aimed to investigate the effect of DAA therapy on sustained virologic response (SVR) among patients with CHC and either active, inactive or no HCC. Methods PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from 1/1/2013 to 9/24/2018. The pooled SVR rates were computed using DerSimonian-Laird random-effects models. Results We included 49 studies from 15 countries, comprised of 3,341 patients with HCC and 35,701 without HCC. Overall, the pooled SVR was lower in patients with HCC than in those without HCC (89.6%, 95% CI 86.8–92.1%, I2 = 79.1% vs. 93.3%, 95% CI 91.9–94.7%, I2 = 95.0%, p = 0.0012), translating to a 4.8% (95% CI 0.2–7.4%) SVR reduction by meta-regression analysis. The largest SVR reduction (18.8%) occurred in patients with active/residual HCC vs. inactive/ablated HCC (SVR 73.1% vs. 92.6%, p = 0.002). Meanwhile, patients with HCC who received a prior liver transplant had higher SVR rates than those who did not (p <0.001). Regarding specific DAA regimens, patients with HCC treated with ledipasvir/sofosbuvir had lower SVR rates than patients without HCC (92.6%, n = 884 vs. 97.8%, n = 13,141, p = 0.026), but heterogeneity was high (I2 = 84.7%, p <0.001). The SVR rate was similar in patients with/without HCC who were treated with ombitasvir/paritaprevir/ritonavir ± dasabuvir (n = 101) (97.2% vs. 94.8%, p = 0.79), or daclatasvir/asunaprevir (91.7% vs. 89.8%, p = 0.66). Conclusion Overall, SVR rates were lower in patients with HCC, especially with active HCC, compared to those without HCC, though heterogeneity was high. Continued efforts are needed to aggressively screen, diagnose, and treat HCC to ensure higher CHC cure rates. Lay summary There are now medications (direct-acting antivirals or “DAAs”) that can “cure” hepatitis C virus, but patients with hepatitis C and liver cancer may be less likely to achieve cure than those without liver cancer. However, patients with liver cancer are also more likely to have advanced liver disease and risk factors that can decrease cure rates, so better controlled studies are needed to confirm these findings. The effect of hepatocellular carcinoma (HCC) on the response to interferon-free direct-acting antiviral (DAA) therapy in patients with chronic hepatitis C (CHC) infection remains unclear. Using a systematic review and meta-analysis approach, we aimed to investigate the effect of DAA therapy on sustained virologic response (SVR) among patients with CHC and either active, inactive or no HCC. PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from 1/1/2013 to 9/24/2018. The pooled SVR rates were computed using DerSimonian-Laird random-effects models. We included 49 studies from 15 countries, comprised of 3,341 patients with HCC and 35,701 without HCC. Overall, the pooled SVR was lower in patients with HCC than in those without HCC (89.6%, 95% CI 86.8–92.1%, I2 = 79.1% vs. 93.3%, 95% CI 91.9–94.7%, I2 = 95.0%, p = 0.0012), translating to a 4.8% (95% CI 0.2–7.4%) SVR reduction by meta-regression analysis. The largest SVR reduction (18.8%) occurred in patients with active/residual HCC vs. inactive/ablated HCC (SVR 73.1% vs. 92.6%, p = 0.002). Meanwhile, patients with HCC who received a prior liver transplant had higher SVR rates than those who did not (p <0.001). Regarding specific DAA regimens, patients with HCC treated with ledipasvir/sofosbuvir had lower SVR rates than patients without HCC (92.6%, n = 884 vs. 97.8%, n = 13,141, p = 0.026), but heterogeneity was high (I2 = 84.7%, p <0.001). The SVR rate was similar in patients with/without HCC who were treated with ombitasvir/paritaprevir/ritonavir ± dasabuvir (n = 101) (97.2% vs. 94.8%, p = 0.79), or daclatasvir/asunaprevir (91.7% vs. 89.8%, p = 0.66). Overall, SVR rates were lower in patients with HCC, especially with active HCC, compared to those without HCC, though heterogeneity was high. Continued efforts are needed to aggressively screen, diagnose, and treat HCC to ensure higher CHC cure rates." @default.
- W2945682340 created "2019-05-29" @default.
- W2945682340 creator A5009887722 @default.
- W2945682340 creator A5011671924 @default.
- W2945682340 creator A5012063237 @default.
- W2945682340 creator A5013930287 @default.
- W2945682340 creator A5017407894 @default.
- W2945682340 creator A5024464961 @default.
- W2945682340 creator A5024721601 @default.
- W2945682340 creator A5026964230 @default.
- W2945682340 creator A5031465104 @default.
- W2945682340 creator A5032091930 @default.
- W2945682340 creator A5034012195 @default.
- W2945682340 creator A5035900623 @default.
- W2945682340 creator A5037472498 @default.
- W2945682340 creator A5046202286 @default.
- W2945682340 creator A5046425635 @default.
- W2945682340 creator A5047338429 @default.
- W2945682340 creator A5050861817 @default.
- W2945682340 creator A5051161148 @default.
- W2945682340 creator A5051932003 @default.
- W2945682340 creator A5057057637 @default.
- W2945682340 creator A5062155863 @default.
- W2945682340 creator A5062432231 @default.
- W2945682340 creator A5062868603 @default.
- W2945682340 creator A5063172143 @default.
- W2945682340 creator A5063504799 @default.
- W2945682340 creator A5067647579 @default.
- W2945682340 creator A5068808737 @default.
- W2945682340 creator A5070930784 @default.
- W2945682340 creator A5071309777 @default.
- W2945682340 creator A5071889616 @default.
- W2945682340 creator A5073284312 @default.
- W2945682340 creator A5076322082 @default.
- W2945682340 creator A5077530077 @default.
- W2945682340 creator A5087440862 @default.
- W2945682340 creator A5090334203 @default.
- W2945682340 date "2019-09-01" @default.
- W2945682340 modified "2023-10-17" @default.
- W2945682340 title "Sustained virologic response to direct-acting antiviral therapy in patients with chronic hepatitis C and hepatocellular carcinoma: A systematic review and meta-analysis" @default.
- W2945682340 cites W1174036299 @default.
- W2945682340 cites W1976118303 @default.
- W2945682340 cites W1979423827 @default.
- W2945682340 cites W2005501262 @default.
- W2945682340 cites W2049971427 @default.
- W2945682340 cites W2060612188 @default.
- W2945682340 cites W2091274801 @default.
- W2945682340 cites W2126956071 @default.
- W2945682340 cites W2133564174 @default.
- W2945682340 cites W2134852288 @default.
- W2945682340 cites W2185218296 @default.
- W2945682340 cites W2257203087 @default.
- W2945682340 cites W2292353902 @default.
- W2945682340 cites W2335913920 @default.
- W2945682340 cites W2399411325 @default.
- W2945682340 cites W2419146391 @default.
- W2945682340 cites W2472585716 @default.
- W2945682340 cites W2485513189 @default.
- W2945682340 cites W2514130042 @default.
- W2945682340 cites W2515859798 @default.
- W2945682340 cites W2523466376 @default.
- W2945682340 cites W2525113725 @default.
- W2945682340 cites W2525705321 @default.
- W2945682340 cites W2527863729 @default.
- W2945682340 cites W2534786401 @default.
- W2945682340 cites W2536951822 @default.
- W2945682340 cites W2547264935 @default.
- W2945682340 cites W2558567422 @default.
- W2945682340 cites W2559958473 @default.
- W2945682340 cites W2565811941 @default.
- W2945682340 cites W2567234545 @default.
- W2945682340 cites W2570363312 @default.
- W2945682340 cites W2578013986 @default.
- W2945682340 cites W2583985389 @default.
- W2945682340 cites W2586792441 @default.
- W2945682340 cites W2587721576 @default.
- W2945682340 cites W2588664246 @default.
- W2945682340 cites W2593387920 @default.
- W2945682340 cites W2598604584 @default.
- W2945682340 cites W2602905880 @default.
- W2945682340 cites W2605698336 @default.
- W2945682340 cites W2605973763 @default.
- W2945682340 cites W2606258780 @default.
- W2945682340 cites W2609928580 @default.
- W2945682340 cites W2613548040 @default.
- W2945682340 cites W2618332520 @default.
- W2945682340 cites W2619031579 @default.
- W2945682340 cites W2626408918 @default.
- W2945682340 cites W2657055765 @default.
- W2945682340 cites W2742937844 @default.
- W2945682340 cites W2743103162 @default.
- W2945682340 cites W2744320025 @default.
- W2945682340 cites W2744956391 @default.
- W2945682340 cites W2748400966 @default.
- W2945682340 cites W2749229801 @default.
- W2945682340 cites W2750407738 @default.
- W2945682340 cites W2752286265 @default.
- W2945682340 cites W2759174138 @default.