title: Interferon-free therapies for patients with chronic hepatitis C genotype 3 infection: A systematic review.
abstract: Treatment of hepatitis C virus (HCV) infection with genotype 3 remains a challenge. The HCV elimination rate with direct-acting antivirals (DAAs) is lower than the values reported for other HCV genotypes. In addition, genotype 3-infected patients have a higher risk of disease progression and hepatocellular carcinoma. The aim of this study was to review the relevant literature concerning the treatment of HCV genotype 3 patients with interferon-free regimens. A literature search was conducted in the PubMed/Medline, Embase and Web of Science electronic databases. Trials enrolling patients with chronic hepatitis C infection treated with DAAs with or without ribavirin were included. Two investigators independently evaluated the trials for inclusion criteria, risk of bias and data extraction. The primary outcome was sustained virological response (SVR). In total, 323 references were identified, and 29 met the inclusion criteria: 18 general clinical trials, three general observational studies, three studies in patients with decompensated liver cirrhosis and four studies in HIV-HCV-coinfected patients. Overall, 4068 genotype 3 patients were included. As compared with sofosbuvir and ribavirin for 24 weeks, sofosbuvir/velpatasvir for 12 weeks or sofosbuvir plus daclatasvir plus ribavirin for 12 weeks provided higher SVR rates, particularly in patients with cirrhosis. Treatment of patients with decompensated cirrhosis remains a great challenge. Sofosbuvir/ledipasvir+ribavirin for 12 weeks were associated with an SVR of 85% in these patients. In summary, treatment of HCV genotype 3 patients is improving rapidly, and this population may no longer be considered a difficult-to-treat subgroup in the near future.
authors.affiliation: Department of Pharmacy, Hospital Universitario Miguel Servet, Zaragoza, Spain.|Faculty of Pharmacy, University of Granada, Granada, Spain.
authors.forename: V
authors.identifier: 0000-0002-9066-7903
authors.initials: V
authors.lastname: Gimeno-Ballester
authors.affiliation: Liver Unit, Hospital Universitario Valle Hebron and Ciberehd del Intituto Carlos III, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Buti
authors.affiliation: Faculty of Pharmacy, University of Granada, Granada, Spain.|Department of Pharmacy, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: San Miguel
authors.affiliation: Liver Unit, Hospital Universitario Valle Hebron and Ciberehd del Intituto Carlos III, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Riveiro
authors.affiliation: Liver Unit, Hospital Universitario Valle Hebron and Ciberehd del Intituto Carlos III, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Esteban
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D060085:Coinfection; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology; D000072230:Sustained Virologic Response; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: chronic hepatitis C; direct antiviral agents; drug therapy; sustained virological response; systematic review; viral hepatitis