title: Role of hepatitis C virus genotype 3 in liver fibrosis progression--a systematic review and meta-analysis.
abstract: The progression of liver fibrosis in chronic hepatitis C has long been considered to be independent from viral genotypes. However, recent studies suggest an association between Hepatitis C virus (HCV) genotype 3 and accelerated liver disease progression. We completed a systematic review and meta-analysis of studies evaluating the association between HCV genotypes and fibrosis progression. PubMed, Embase and ISI Web of Knowledge databases were searched for cohort, cross-sectional and case-control studies on treatment-naïve HCV-infected adults in which liver fibrosis progression rate (FPR) was assessed by the ratio of fibrosis stage in one single biopsy to the duration of infection (single-biopsy studies) or from the change in fibrosis stage between two biopsies (paired biopsies studies). A random effect model was used to derive FPR among different HCV genotypes. Eight single-biopsy studies (3182 patients, mean/median duration of infection ranging from 9 to 21 years) and eight paired biopsies studies (mean interval between biopsies 2-12 years) met the selection criteria. The odds ratio for the association of genotype 3 with accelerated fibrosis progression was 1.52 (95% CI 1.12-2.07, P = 0.007) in single-biopsy studies and 1.37 (95% CI 0.87-2.17, P = 0.17) in paired biopsy studies. In conclusion, viral genotype 3 was associated with faster fibrosis progression in single-biopsy studies. This observation may have important consequences on the clinical management of genotype 3-infected patients. The association was not significant in paired biopsies studies, although the latter may be limited by important indication bias, short observation time and small sample size.
authors: Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland.
authors: A
authors: A
authors: Probst
authors: T
authors: T
authors: Dang
authors: M
authors: M
authors: Bochud
authors: M
authors: M
authors: Egger
authors: F
authors: F
authors: Negro
authors: P-Y
authors: PY
authors: Bochud
mesh_terms: D001706:Biopsy; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000472:pathogenicity*; D019698:Hepatitis C, Chronic / Q000235:genetics / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000821:virology; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D016017:Odds Ratio; D012307:Risk Factors