Meta-Analysis
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World J Gastroenterol. Jun 21, 2014; 20(23): 7505-7513
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7505
Interferon-associated retinopathy risk in patients with diabetes and hypertensive hepatitis C
Ji-Hua Xue, Hai-Hong Zhu, Jing Wang, Zhi Chen
Ji-Hua Xue, Hai-Hong Zhu, Jing Wang, Zhi Chen, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xue JH and Zhu HH designed the research; Xue JH and Wang J performed the searches and data collection; Zhu HH and Chen Z supervised the research; Xue JH and Chen Z analyzed the data; Xue JH and Wang J wrote the paper.
Supported by National Natural Science Foundation of China, No. 81201291; National Science and Technology Major Project, No.2012ZX10002003; and Science and Technology Major Projects of Zhejiang Province, No. 2009C03011-2
Correspondence to: Zhi Chen, PhD, MD, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zju.zhichen@gmail.com
Telephone: +86-571-87236579 Fax: +86-571-87068731
Received: October 8, 2013
Revised: February 11, 2014
Accepted: March 4, 2014
Published online: June 21, 2014
Abstract

AIM: To investigate the association of hypertension and diabetes mellitus (DM) with interferon-associated retinopathy (IAR) risk in chronic hepatitis C (CHC).

METHODS: Two investigators independently searched PubMed and Embase for eligible articles published prior to December 2013; additional studies were identified by reviewing the bibliographies. Only case-control or cohort studies that evaluated the association between hypertension and/or DM and IAR incidence in CHC patients were included. IAR was characterized by the presence of cotton-wool spots and/or retinal hemorrhage, and was defined as the primary efficacy measure. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were estimated using data extracted from papers based on random-effects models.

RESULTS: Eight eligible studies were included in the present meta-analysis. The outcomes showed that patients with CHC and hypertension were at higher risk of IAR (48/189 vs 96/455, RR = 1.90; 95%CI: 1.15-3.15, P < 0.05). Patients with DM receiving interferon (IFN)-based therapy for CHC infection may be at higher risk for IAR (18/72 vs 60/256, RR = 1.56, 95%CI: 1.11-2.20, P < 0.05); however, the outcome was not stable. There was no significant difference in IAR risk between genotype-1-infected patients and non-genotype-1-infected patients (RR = 1.09, 95%CI: 0.64-1.87, P > 0.05). Comparable incidences of IAR were also found between patients treated with pegylated interferon (PIFN) α-2a and those treated with PIFN α-2b (RR = 0.84, 95%CI: 0.56-1.24, P > 0.05) and between patients treated with IFN α and those treated with PIFN α (RR = 1.04, 95%CI: 0.72-1.50, P > 0.05).

CONCLUSION: Patients with hypertension have a higher risk of retinopathy when receiving IFN-based therapy for CHC.

Keywords: Hepatitis C infection, Interferon-associated retinopathy, Hypertension, Diabetes mellitus, Interferon

Core tip: This meta-analysis demonstrated that patients with hypertension were at higher risk for developing retinopathy when receiving interferon-based therapy for chronic hepatitis C infection. Further studies are needed to clarify the association between diabetes mellitus and interferon-associated retinopathy.