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Pegylated and non-pegylated interferon-alfa and ribavirin for the treatment of mild chronic hepatitis C: A systematic review and meta-analysis

Record type: Article

Objectives: traditionally, patients with chronic hepatitis C virus (HCV) infection have not received treatment until their infection reaches the moderate to severe stage. The aim of this systematic review was to assess the clinical effectiveness of pegylated (PEG) and non-pegylated interferon (IFN) alfa and ribavirin (RBV) for the treatment of adults with histologically mild HCV.

Methods: we performed a sensitive search of fourteen electronic bibliographic databases for literature that met criteria defined in a research protocol. Two reviewers independently selected studies, extracted data and assessed methodological quality.

Results: ten randomized, controlled trials (RCTs) were included. Treatment with PEG + RBV combination therapy resulted in significantly higher sustained virological response (SVR) rates than treatment with IFN + RBV combination therapy. Treatment for 48 weeks with PEG + RBV was significantly more effective than the same treatment for 24 weeks. Significantly higher SVR rates were seen with IFN + RBV compared with either IFN monotherapy or no treatment. In the meta-analysis (four IFN trials), the relative risk of not experiencing an SVR was 0.59 (95 percent CI, 0.51 – 0.69) and was statistically significant (p < .00001). SVRs were higher for patients with genotype non-1 compared with genotype 1 for both PEG + RBV and IFN + RBV treatments.

Conclusions: patients with histologically mild HCV can be successfully treated with both PEG and IFN combination therapy, and response rates are broadly comparable with those achieved in patients with advanced disease. Treating patients in the early milder stages of HCV is, therefore, a clinically effective option

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Citation

Hartwell, Debbie and Shepherd, Jonathan (2009) Pegylated and non-pegylated interferon-alfa and ribavirin for the treatment of mild chronic hepatitis C: A systematic review and meta-analysis International Journal of Technology Assessment in Health Care, 25, (1), pp. 56-62. (doi:10.1017/S0266462309090084). (PMID:19126252).

More information

Published date: 6 January 2009
Keywords: mild hepatitis C, pegylated interferon-alfa, non-pegylated interferon-alfa, ribavirin, systematic review
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 200941
URI: http://eprints.soton.ac.uk/id/eprint/200941
ISSN: 0266-4623
PURE UUID: eaf28a5e-301e-41fe-92b3-13b5b1e1579b

Catalogue record

Date deposited: 27 Oct 2011 07:46
Last modified: 18 Jul 2017 11:13

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Contributors

Author: Debbie Hartwell

University divisions


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