Studies
comparing treatment outcomes of CFTR modulator PEG IFN+RBV for HCV-4 with HCV-1 and 2/3 have been limited by the small sample size of the HCV-4 group. We aimed to compare SVR and predictors of SVR in HCV-4 versus HCV-1 and HCV-2/3 patients treated with PEG-IFN+RBV in a meta-analysis. Methods: We performed a comprehensive literature search in MEDLINE and EMBASE for ‘genotype 4′ in November 2013 and reviewed abstracts from 2012-2013 AASLD, APASL, DDW, and EASL. Inclusion criteria were original studies with ≥25 treatment-naïve HCV-4 patients with direct comparison arms with HCV-1, 2, and/or 3 patients, and all treated with PEG IFN+RBV. Exclusion criteria were co-infection with HIV, HBV, or other HCV genotypes. We used random-effects models to estimate effect sizes and Cochrane Q-test (p-value <0.05) and I2 statistic (>50%) to estimate level of heterogeneity. Results: We included 6 studies
(868 HCV-4, 12,033 HCV-1, and 7,194 HCV-2/3 patients) in the primary analysis. Overall SVR was 53% (CI: 43-62%) for HCV-4, 44% (CI: 40-47%) for HCV-1, and 73% (CI: 58-84%) for HCV-2/3 (Table 1). EVR rates were higher for HCV-4 [72% (CI: 64-81%)] compared to HCV-1, [59% (CI: 58-61%)]. SVR in those patients Proteasome inhibitor 上海皓元 with EVR were 75% (CI: 61-86%) in HCV-4 and 64% (CI: 46-79%) in HCV-1. SVR in patients who did not achieve EVR were 10% (CI: 6-17%) for HCV-4, 13% (CI: 12-15%) for HCV-1 and higher for HCV-2/3 at 23% (CI: 16-33%). Conclusions: Pooled SVR rates were lowest for HCV-1 (44%) then HCV-4 (53%) and highest for HCV-2/3 (73%). EVR was not a good stopping
rule for HCV-2/3 but excellent for HCV-1 and 4, so patients can seek alternative therapy early. However, approximately three-quarter of HCV-4 patients treated with PEG IFN+RBV achieved EVR and three-quarter of these patients also achieved SVR, making this a reasonable treatment option for HCV-4 patients. Treatment Response: HCV-4 compared to HCV-1 or HCV-2/3 Disclosures: Mindie H. Nguyen – Advisory Committees or Review Panels: Bristol-Myers Squibb, Bayer AG, Gilead, Novartis, Onyx; Consulting: Gilead Sciences, Inc.; Grant/Research Support: Gilead Sciences, Inc., Bristol-Myers Squibb, Novartis Pharmaceuticals, Roche Pharma AG, Idenix, Hologic, ISIS The following people have nothing to disclose: Brittany E. Yee, Derek Lin, Nghia H. Nguyen, Bing Zhang, Philip Vutien, Carrie R. Wong, Glen A.
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