Efficacy and safety of direct-acting antiviral regimen for patients with hepatitis C virus genotype 2: A systematic review and meta-analysis

Abstract

AbstractBackgroundDirect-acting antivirals (DAAs) show high cure rates in treating chronic hepatitis C virus (HCV). However, the effect of DAAs on patients infected with genotype 2 (GT2) is difficult to determine despite the availability of several DAA regimens.MethodsA systematic search of six databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Clinicaltrial.gov) was conducted through April 20, 2022. We considered the sustained virological response 12 weeks after treatment (SVR12) as the efficacy outcome, and adverse events (AEs) as the safety outcome. By calculating the mean SVR12 and the proportion of AEs among patients, we considered the intervention effect for each DAA regimen. The random effect model was then used in all meta-analyses. This systematic review and meta-analysis aimed to summarize the evidence on efficacy and safety of DAAs in patients infected with HCV GT2.ResultsAmong 31 articles included (2,968 participants), consisting of 1,387 treatment-naive patients and 354 patients with cirrhosis. The overall pooled SVR12 rate was 94.62% (95% CI: 92.43%-96.52%) among the participants who received all doses of treatment. Meta-analysis results of AEs revealed that fatigue was the most common AE (14.0%, 95% CI: 6.4%-21.6%), followed by headache (13.1%, 95% CI: 9.2%-17.1%), whereas death and serious adverse events were uncommon.Conclusions: We compared DAA-based treatments indirectly using meta-analysis and found regimens containing sofosbuvir and velpatasvir for 12 weeks to be the relatively safe and most effective option for HCV GT2 patients.