Qu Yundong, Guo Ying, Li Tao, Ye Qian, Sun Chao, Wang Lei, Yang Baohua
Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, Shandong, China.
Department of Intensive Care Unit, The Second Hospital of Shandong University, Jinan, Shandong, China.
J Gastroenterol Hepatol. 2017 Apr;32(4):740-748. doi: 10.1111/jgh.13614.
The aim of this study is to assess the efficacy and safety of sofosbuvir-based interferon-free therapies in liver transplantation recipients with hepatitis C virus infection recurrence.
A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and CENTRAL on the Cochrane Library without time or language limitation. The search strategy used was "sofosbuvir AND transplantation." Sustained virologic response at 12 weeks after the end of treatment (SVR12) rate, incidence of serious adverse events (SAEs) and/or adverse events, discontinuation rate with 95% confidence intervals (CI) were pooled with random-effects model.
Twenty-two studies (1730 patients) were included for our meta-analysis. The pooled SVR12 rate was 90.1% (95% CI 86.4-93.4%, I = 81.6%). SVR12 rate was higher in patients with mild fibrosis than in patients with advanced fibrosis and cirrhosis (RR = 1.072, 95% CI 1.031-1.115, I = 3.6%). For patients with hepatitis C virus genotype 1, the pooled SVR12 rate was 91.9% (95% CI 89.2-94.2%, I = 53.3%). The pooled SAEs incidence was 8.3% (95% CI 5.6-11.5%, I = 78.4%). The pooled discontinuation rate because of adverse events or SAEs was 3.3% (95% CI 1.8-5.2%).
Sofosbuvir-based interferon-free therapy is an effective and well-tolerated treatment strategy for patients with hepatitis C virus infection recurrence after liver transplantation.
本研究旨在评估基于索磷布韦的无干扰素疗法对丙型肝炎病毒感染复发的肝移植受者的疗效和安全性。
在PubMed、EMBASE、科学网和Cochrane图书馆的CENTRAL中进行了系统的文献检索，无时间或语言限制。使用的检索策略为“索磷布韦与移植”。治疗结束后12周的持续病毒学应答（SVR12）率、严重不良事件（SAE）和/或不良事件的发生率、停药率及95%置信区间（CI）采用随机效应模型进行汇总。
纳入22项研究（1730例患者）进行荟萃分析。汇总的SVR12率为90.1%（95%CI 86.4 - 93.4%，I² = 81.6%）。轻度纤维化患者的SVR12率高于重度纤维化和肝硬化患者（RR = 1.072，95%CI 1.031 - 1.115，I² = 3.6%）。对于丙型肝炎病毒基因1型患者，汇总的SVR12率为91.9%（95%CI 89.2 - 94.2%，I² = 53.3%）。汇总的SAE发生率为8.3%（95%CI 5.6 - 11.5%，I² = 78.4%）。因不良事件或SAE导致的汇总停药率为3.3%（95%CI 1.8 - 5.2%）。
基于索磷布韦的无干扰素疗法是肝移植后丙型肝炎病毒感染复发患者的一种有效且耐受性良好的治疗策略。
