Optimal Duration of Treatment for HCV Genotype 1 Infection in Slow Responders: A Meta-Analysis

BACKGROUND A head-to-head comparison of the 72-week and 48-week anti-HCV therapies in slow responders with genotype 1 infection has been performed in several randomized clinical trials (RCTs). OBJECTIVES This review aimed at summarizing and pooling the results of these studies. MATERIALS AND METHODS RCTs that had evaluated the 72-week vs. 48-week anti-HCV therapy (peginterferon and ribavirin) in slow responders with HCV genotype 1 infection were systematically identified. A meta-analysis was performed using the random effects model. Heterogeneity in results was assessed on the basis of the Q statistics, and publication bias was evaluated by using Harbord's modified test. The end point was set as a sustained virological response (SVR). RESULTS Data of 1206 subjects were retrieved from 7 studies. A total of 631 patients had received extended therapy. Slow virological responders who received the 72-week therapy had a significantly higher probability of achieving SVR than their counterpartswho received the 48-week therapy [RR = 1.44 (95% CI, 1.20-1.73)]. With regard to publication biases, the heterogeneity in funnel plots was not significant (P = 0.19, I2 = 30%, PHarbord = 0.1). CONCLUSION Our meta-analysis showed that the 72-week therapy with peginterferon and ibavirin is significantly superior to the standard 48-week therapy in slow responders th HCV genotype 1 infection.