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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Efficacy and safety of sofosbuvir/velpatasvir with or without ribavirin in hepatitis C genotype 3 compensated cirrhosis: A meta-analysis
Jing Hong Loo, Wen Xin Flora Xu, Jun Teck Low, Wei Xuan Tay, Le Shaun Ang, Yew Chong Tam, Prem Harichander Thurairajah, Rahul Kumar, Yu Jun Wong
Jing Hong Loo, Wen Xin Flora Xu, Jun Teck Low, Wei Xuan Tay, Le Shaun Ang, Prem Harichander Thurairajah, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
Yew Chong Tam, Education Resource Center, Medical Board, Singapore General Hospital, Singapore 100059, Singapore
Prem Harichander Thurairajah, Department of Gastroenterology and Hepatology, National University Hospital, Singapore 119077, Singapore
Rahul Kumar, Yu Jun Wong, Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore 529889, Singapore
Rahul Kumar, Yu Jun Wong, Duke-NUS Medicine Academic Clinical Program, Singapore 100059, Singapore
Author contributions: Loo JH and Xu WXF contributed equally as the first-author; Wong YJ contributed to study concept and design; Loo JH, Tay WX, Low JT, Ang LS, Xu WXF contributed to systematic review of literature; Loo JH, Xu WXF contributed to drafting of manuscript; all authors did critical review of manuscript.
Supported by the Nurturing Clinician Scientist Scheme (NCCS) award by SingHealth Duke-NUS Academic Medical Centre and National Medical Research Council Singapore.
Conflict-of-interest statement: Dr. Wong YJ was an invited speaker for Gilead Science. Other authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yu Jun Wong , FRCP, MD, Consultant Physician-Scientist, Department of Gastroenterology and Hepatology, Changi General Hospital, Singhealth, 2, Simei Street 3, Singapore 529889, Singapore. eugene.wong.y.j@singhealth.com.sg
Received: August 8, 2021
Peer-review started: August 8, 2021
First decision: November 11, 2021
Revised: November 18, 2021
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: June 27, 2022
ARTICLE HIGHLIGHTS
Research background
With direct-acting antiviral therapy that is safe, effective and simple to use, future research should address linkage of care of hepatitis C virus (HCV) to achieve elimination.
Research motivation
As ribavirin (RBV) is associated with a higher risk of treatment-related adverse events, RBV as routine add-on therapy to sofosbuvir/velpatasvir (SOF/VEL) should be reconsidered among compensated genotype 3 (GT3) cirrhosis patients.
Research objectives
RBV as routine add-on therapy was not associated with higher sustained virological response at 12 wk post-treatment (SVR12) in GT3 compensated cirrhosis patients receiving SOF/VEL.
Research methods
Systematic review and meta-analysis.
Research results
Our study aimed to evaluate the efficacy and safety of SOF/VEL, with or without RBV in GT3 compensated cirrhosis patients.
Research conclusions
In routine clinical practice, the application of pretreatment resistance-associated substitution testing for patients with GT3 compensated cirrhosis is often limited by cost and availability. Moreover, such a strategy should be balanced with the need for closer monitoring for adverse events from RBV such as anemia. In order to address these gaps, we performed a systematic review and meta-analysis to compare the efficacy and safety of RBV in GT3 compensated cirrhosis patients treated with SOF/VEL.
Research perspectives
SOF/VEL is an effective pan-genotypic direct-acting antiviral combination for the treatment of chronic HCV infection. While the addition of RBV to SOF/VEL improved SVR12 in GT3 decompensated cirrhosis patients, the benefits of RBV in GT3 compensated cirrhosis patients receiving SOF/VEL remains unclear.
