Outcome of antiviral therapy in Egyptian Hepatitis C Virus (HCV) genotype 4 patients with advanced liver fibrosis

Khattib, Ahmed A. El; Abdelhakam, Sara M.; Ghoraba, Dalia; Ibrahim, Wesam A.; Sayed, Moataz M.

doi:10.1016/j.ejim.2011.10.003

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Six were redundant[49, 51, 57, 68, 89, 99] and four were not relevant[30, 43, 60, 94]. Two studies did not contain original data[52, 98]. Three studies did not evaluate treatment-naïve patients[31, 32, 97], one study did not have at least 25 HCV-4 patients[33], and three studies included patients co-infected with hepatitis B virus, HIV, or other liver diseases[44, 70, 82].…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis

Yee

Nguyen

Zhang

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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Background The burden of hepatitis C virus genotype 4 (HCV-4) is high in Africa and East Mediterranean countries. Previous reports estimate sustained virologic response (SVR) rates in HCV-4 to be ~20–70%. However, many of these studies are limited by different study designs and small sample sizes. Aim Our aim was to evaluate treatment outcome and host/viral factors on SVR in HCV-4 patients treated with pegylated interferon and ribavirin (PEG IFN+RBV) in a systematic and quantitative fashion. Methods A comprehensive literature search in MEDLINE and EMBASE for ‘genotype 4’ was conducted in November 2013. Abstracts from AASLD, APASL, DDW, and EASL in 2012/2013 were reviewed. Inclusion criteria were original studies with ≥25 treatment-naïve HCV-4 patients treated with PEG IFN+RBV. Exclusion criteria were co-infection with HIV, HBV, or other genotypes. Effect sizes were calculated using random-effects models. Heterogeneity was determined by Cochrane Q-test (p-value <0.05) and I-squared statistic (>50%). Results We included 51 studies (11,102 HCV-4 patients) in the primary analysis. Pooled SVR was 53% (95% CI: 50–55%) (Q-statistic = 269.20, p<0.05; I2 = 81.43). On sub-group analyses, SVR was significantly associated with lower viral load, OR 3.05 (CI 1.80–5.17, p<0.001); mild fibrosis, OR 3.17 (CI 2.19–4.59, p<0.001); and favorable IL28B polymorphisms, rs12979860 CC versus CT/TT, OR 4.70 (CI 2.87–7.69, p<0.001), and rs8099917 TT versus GT/GG, OR 5.21 (CI 2.31–11.73, p<0.001). Conclusions HCV-4 patients treated with PEG IFN+RBV may expect SVR rate of ~50%. Lower viral load, mild fibrosis, and favorable IL28B (rs12979860 CC and rs8099917 TT) are positively associated with SVR.

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Section: Resultsmentioning

confidence: 99%

Meta-analysis

Yee

Nguyen

Zhang

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…Nucleotide blast analysis (ncbi.nlm.nih.gov) of our HCV-E2 partial sequence revealed partial homology with previously published E2-genes of viral isolates from different locations such as Egypt, Japan, USA, UK and others .The highest extent of homology (88%) was annotated with the sequence of hepatitis C virus subtype 4a genomic RNA, complete genome, isolate: HCV genotype 4a-KM (AB795432.1,Tsukiyama-Kohara, K. and Michinori Kohara, 2013 (unpublished)), which further confirms the successful amplification of the HCV-E2 fragment and strongly suggest a correlation between such sequence variation and the resistance of Egyptian HCV 4a -infected patients to any HCV therapy including the novel ones containing the protease inhibitors [18]. The descending order of the homology of our HCV-E2 partial nucleotide sequence with previously published ones is presented in Table (2).…”

Section: Homology Of the Obtained Sequence With Previously Published mentioning

confidence: 77%

Characterization of a Partial Sequence Encoding Envelop Protein of HCV-Genotype 4a Egyptian Isolate

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2014

IOSRJPBS

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In this study, RNA isolated from sera of Egyptian HCV-patients was used to amplify a fragment of a M. wt. of ~800pb corresponding to a partial sequence of the HCV-E2 encoding gene. The amplified fragment was cloned, sequenced and the nucleotide blast analysis of our sequence revealed partial homology with previously published E2-genes of viral isolates from different locations; the highest match (88%) was annotated with a Japanese isolate suggesting that our herein characterized HCV-E2 partial sequence is a novel one. The impact of HCV-E2 sequence variability will be discussed.

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“…Eighty-four studies were closely reviewed. 7 10–59 61–93 A total of 79 studies were excluded for the following reasons: 45 studies did not have direct comparison arms of HCV-1, 2, and/or 3; 7 10–13 15–31 33–39 41 44 45 47–59 14 studies did not have accessible treatment outcomes data; 61 62 67 70 72 76 78 79 82 84 85 87 92 93 6 studies were redundant; 71 73 75 80 86 91 4 studies were not relevant; 63 68 77 88 3 studies included patients coinfected with other conditions, including hepatitis B virus, HIV or other liver diseases; 69 81 83 3 studies did not assess treatment-naïve patients; 64 65 89 2 studies did not contain original data; 74 90 1 study did not meet our minimum sample size requirement of at least 25 HCV patients; 66 1 study did not include patients treated for 48 weeks. 40 A total of five studies met all eligibility criteria and were included in the primary analysis.…”

Section: Resultsmentioning

confidence: 99%

Sustained virological response and its treatment predictors in hepatitis C virus genotype 4 compared to genotypes 1, 2, and 3: a meta-analysis

Yee

Nguyen

Zhang

et al. 2015

BMJ Open Gastroenterol

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BackgroundPegylated interferon and ribavirin (PEG-IFN+RBV) may be more cost-effective than direct-acting antivirals in resource-limited settings. Current literature suggests sustained virological response (SVR) in hepatitis C virus genotype 4 (HCV-4) is similar to genotype 1 (HCV-1), but worse than 2 and 3 (HCV-2/3). However, few studies have compared treatment response between these groups and these have been limited by small sample sizes with heterogeneous designs. We performed a meta-analysis of SVR predictors in HCV-4 versus HCV-1, 2, and 3 patients treated with PEG-IFN+RBV.MethodsIn November 2013, we searched for ‘genotype 4’ in MEDLINE/EMBASE databases and scientific conferences. We included original articles with ≥25 treatment-naïve HCV-4 and comparisons to HCV-1, 2, and/or 3 patients treated with PEG-IFN+RBV. Random effects modelling was used with heterogeneity defined by Cochrane Q-test (p value<0.10) and I2 statistic (>50%).ResultsFive studies with 20 014 patients (899 HCV-4; 12 033 HCV-1; and 7082 HCV-2/3 patients) were included. SVR was 53% (CI 43% to 62%) for HCV-4, 44% (CI 40% to 47%) for HCV-1; and 73% (CI 58% to 84%) for HCV-2/3. SVR with EVR (early virological response) was 75% (CI 61% to 86%) in HCV-4; 64% (CI 46% to 79%) in HCV-1; and 85% (CI 71% to 93%) in HCV-2/3. SVR without EVR was 10% (CI 6% to 17%) for HCV-4; 13% (CI 12% to 15%) for HCV-1; and 23% (CI 16% to 33%) for HCV-2/3.ConclusionsSVR rates are similar in HCV-4 (∼50%) and HCV-1 (∼40%). Lack of EVR is a good stopping rule for HCV-4 and HCV-1 since only 10% subsequently achieve SVR. In HCV-4 patients with EVR, three-quarters can expect to achieve SVR with PEG-IFN+RBV.

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Outcome of antiviral therapy in Egyptian Hepatitis C Virus (HCV) genotype 4 patients with advanced liver fibrosis

Cited by 4 publications

References 6 publications

Meta-analysis

Meta-analysis

Characterization of a Partial Sequence Encoding Envelop Protein of HCV-Genotype 4a Egyptian Isolate

Sustained virological response and its treatment predictors in hepatitis C virus genotype 4 compared to genotypes 1, 2, and 3: a meta-analysis

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