title: Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response.
abstract: BACKGROUND
  Achievement of a sustained virologic response (SVR) after treatment for Hepatitis C infection is associated with improved outcomes. This meta-analysis aimed to determine the impact of SVR on long-term mortality risk compared with nonresponders in a range of populations.
  
  
  METHODS
  An electronic search identified all studies assessing all-cause mortality in SVR and non-SVR patients. Eligible articles were stratified into general, cirrhotic, and populations coinfected with human immunodeficiency virus. The adjusted hazard ratio (95% confidence interval [CI]) for mortality in patients achieving SVR vs non-SVR, and pooled estimates for the 5-year mortality in each group were calculated.
  
  
  RESULTS
  31 studies (n = 33 360) were identified as suitable for inclusion. Median follow-up time was 5.4 years (interquartile range, 4.9-7.5) across all studies. The adjusted hazard ratio of mortality for patients achieving SVR vs non-SVR was 0.50 (95% CI, .37-.67) in the general population, 0.26 (95% CI, .18-.74) in the cirrhotic group, and 0.21 (.10-.45) in the coinfected group. The pooled 5-year mortality rates were significantly lower for patients achieving SVR compared with non-SVR in all 3 populations.
  
  
  CONCLUSIONS
  The results suggest that there is a significant survival benefit of achieving an SVR compared with unsuccessful treatment in a range of populations infected with hepatitis C virus.
authors.affiliation: Division of Medicine, Imperial College London.
authors.forename: Bryony
authors.initials: B
authors.lastname: Simmons
authors.affiliation: Division of Medicine, Imperial College London.
authors.forename: Jawaad
authors.initials: J
authors.lastname: Saleem
authors.affiliation: Division of Medicine, Imperial College London.
authors.forename: Katherine
authors.initials: K
authors.lastname: Heath
authors.affiliation: Division of Medicine, Imperial College London.
authors.forename: Graham S
authors.initials: GS
authors.lastname: Cooke
authors.affiliation: Pharmacology and Therapeutics, Liverpool University, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: hepatitis C; mortality; survival; sustained virologic response