Luo Aoran, Xu Pan, Wang Jin, Li Zuli, Wang Shunli, Jiang Xiaoyan, Ren Hong, Luo Qiang
Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, PR China.
Medicine (Baltimore). 2019 May;98(20):e15626. doi: 10.1097/MD.0000000000015626.
Because of the heterogeneity of hepatitis C virus (HCV) distribution of different genotypes, large-scale clinical trials on direct-acting antiviral (DAA) mainly included patients with genotype 1 and genotype 3 infection. Data on the efficacy of direct-acting antiviral agents in patients with chronic genotype 6 HCV infection are limited.
The PubMed, Embase, and the Cochrane Libraries were searched comprehensively. All published clinical trials assessing the efficacy of DAA therapy for patients with chronic genotype 6 HCV infection were included. Sustained virological response (SVR) and rapid virological response (RVR) were pooled. Additional meta-analyses were also performed to compare the efficacy of DAA therapy in HCV-6 versus HCV-1 or HCV-3 patients.
Seventeen studies met the inclusion criteria and were included in our meta-analysis. The pooled SVR of all single arms was 95% [95% confidence interval (CI): 0.90-0.97]. The pooled RVR of all single arms was 97% (95% CI: 0.95-0.99). The SVR and RVR were both similar between HCV-6 and HCV-1 or HCV-3. Adverse events were common but rarely caused treatment interruption.
Based on the available data, our results indicate that DAA treatment is effective and safe for patients with genotype 6 HCV infection, and the efficacy was similar compared to patients with genotype 1 HCV or genotype 3 HCV infection.
由于丙型肝炎病毒（HCV）不同基因型分布的异质性，直接抗病毒药物（DAA）的大规模临床试验主要纳入了基因型1和基因型3感染的患者。关于直接抗病毒药物对慢性基因型6 HCV感染患者疗效的数据有限。
全面检索了PubMed、Embase和Cochrane图书馆。纳入所有评估DAA治疗慢性基因型6 HCV感染患者疗效的已发表临床试验。汇总持续病毒学应答（SVR）和快速病毒学应答（RVR）。还进行了额外的荟萃分析，以比较DAA治疗在HCV-6患者与HCV-1或HCV-3患者中的疗效。
17项研究符合纳入标准并纳入我们的荟萃分析。所有单臂的汇总SVR为95%[95%置信区间（CI）：0.90-0.97]。所有单臂的汇总RVR为97%（95%CI：0.95-0.99）。HCV-6与HCV-1或HCV-3之间的SVR和RVR均相似。不良事件很常见，但很少导致治疗中断。
根据现有数据，我们的结果表明，DAA治疗对基因型6 HCV感染患者有效且安全，与基因型1 HCV或基因型3 HCV感染患者相比，疗效相似。
