Antiviral Treatment for Hepatitis C Is Associated With a Reduced Risk of Periprosthetic Joint Infection: A Meta-Analysis of Observational Studies

Cheng, Tao; Xu, Dongdong; Yan, Zixiao; Ding, Cheng; Yang, Chao; Zhang, Xianlong

doi:10.1016/j.arth.2022.04.027

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…Infection with HIV and HCV likely increases the risk for complications after THA and TKA based on our findings. The benefits of pre-operative treatment with antivirals in HCV patients were assessed by Cheng et al (2022) with their SR of eight studies [ 34 ]. Among patients who had TKA and THA, compared to those who did not receive antiviral therapy pre-operatively, those who did had significantly lower incidences of overall complications in THA but not TKA, surgical complications for both THA and TKA and PJIs for both THA and TKA.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

et al. 2023

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Introduction This study aimed to present and critically appraise the best available evidence investigating associations between some pre-defined patient-related characteristics and perioperative complications or other outcomes in THA and TKA. Methods Electronic databases were searched (Medline, EMBASE, Scopus, CENTRAL) for systematic reviews assessing the following pre-defined patient-related characteristics as possible risk factors for worse peri-operative outcomes in THA and TKA: smoking, alcohol excess, rheumatoid arthritis, human immunodeficiency virus infection, hepatitis C virus infection, mental health conditions, and solid organ transplantation. Our primary outcome was periprosthetic joint infection. Results were analysed separately for THA, TKA and THA/TKA (mixed data). Results Based on at least two systematic reviews being in agreement, the following patient-related characteristics were associated with increased incidence of complications as follows: a) Smoking for all-cause revision in THA, for periprosthetic joint infection in TKA and THA/TKA; b) alcohol excess for periprosthetic joint infection in THA/TKA; c) human immunodeficiency virus for periprosthetic joint infection in THA/TKA; d) hepatitis C virus for overall complications, periprosthetic joint infection and all-cause revision in THA and THA/TKA, and for overall complications in TKA. Our study found conflicting evidence for a) smoking as a risk factor for periprosthetic joint infection and aseptic loosening in THA; b) human immunodeficiency virus as a risk factor for all-cause revision for THA/TKA; c) hepatitis C virus as a risk factor for periprosthetic joint infection and all-cause revision in TKA. No certainty of evidence was assigned to these results as this was not assessed by the authors of the majority of the included systematic reviews. Conclusion We found that smoking, excess alcohol consumption, RA, and infection with HIV and HCV were associated with a higher incidence of periprosthetic joint infection in one or both of THA and TKA or mixed THA/TKA data. All our results should be interpreted and communicated to patients with caution as the quality of the included systematic reviews was generally poor.

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Section: Discussionmentioning

confidence: 99%

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

et al. 2023

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“…These advances have stimulated interest into the feasibility, practicality and potential benefits of preoperative treatment of hepatitis C prior to undergoing TJA ( 6 , 7 , 8 , 9 ). More recently, a published meta-analysis of observational studies suggests that anti-viral treatment for chronic hepatitis C is associated with a reduced risk of PJI ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of postoperative outcomes of patients with and without chronic hepatitis C undergoing primary total hip or knee arthroplasty

et al. 2023

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Purpose This investigation provides a rigorous systematic review of the postoperative outcomes of patients with and without chronic hepatitis C who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods We queried PubMed, Embase, Cochrane Database of Systematic Reviews, Scopus, Web of Science and the ‘gray’ literature, including supplemental materials, conference abstracts and proceedings as well as commentary published in various peer-reviewed journals from 1992 to present to evaluate studies that compared the postoperative outcomes of patients with and without chronic hepatitis C who underwent primary THA or TKA. This investigation was registered in the PROSPERO international prospective register of systematic reviews and follows the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In our literature search, we identified 14 articles that met our inclusion criteria and were included in our fixed-effects meta-analysis. The postoperative outcomes analyzed included periprosthetic joint infection (PJI), aseptic revision, non-homebound discharge and inpatient mortality. Results Our statistical analysis demonstrated a statistically significant increase in postoperative complications of patients with chronic hepatitis C who underwent primary THA or TKA including PJI (odds ratio (OR): 1.98, 95% CI: 1.86 – 2.10), aseptic revision (OR: 1.58, 95% CI: 1.50 – 1.67), non-homebound discharge (OR: 1.31, 95% CI: 1.28– 1.34) and inpatient mortality (OR: 9.37, 95% CI: 8.17 – 10.75). Conclusion This meta-analysis demonstrated a statistically significant increase in adverse postoperative complications in patients with chronic hepatitis C who underwent primary THA or TKA compared to patients without chronic hepatitis C.

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Treating Hepatitis C Prior to Total Hip Arthroplasty is Cost-effective: A Markov Analysis

Anoushiravani

Kalyanasundaram

Feng³

et al. 2023

The Journal of Arthroplasty

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Antiviral Treatment for Hepatitis C Is Associated With a Reduced Risk of Periprosthetic Joint Infection: A Meta-Analysis of Observational Studies

Cited by 4 publications

References 30 publications

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

A meta-analysis of postoperative outcomes of patients with and without chronic hepatitis C undergoing primary total hip or knee arthroplasty

Treating Hepatitis C Prior to Total Hip Arthroplasty is Cost-effective: A Markov Analysis

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