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lüll Meta-analysis: a randomized trial of peginterferon plus ribavirin for the initial treatment of chronic hepatitis C genotype 4 Khuroo MS; Khuroo MS; Dahab STAliment Pharmacol Ther 2004[Nov]; 20 (9): 931-8BACKGROUND: Guidelines for treatment of patients infected with hepatitis C virus genotype 4 are not available. AIM: To perform a meta-analysis of randomized controlled trials comparing peginterferon plus ribavirin with interferon plus ribavirin treatment in treatment-naive patients infected with chronic hepatitis C virus genotype 4. METHODS: The outcome measure was sustained virologic response. The measure of association employed was relative risk calculated by the random-effect model, with heterogeneity, sensitivity and subgroup analyses. RESULTS: Of the 565 studies screened, six randomized controlled trials including 424 patients (peginterferon plus ribavirin 219, interferon plus ribavirin 205) were analysed. Duration of therapy was 1 year in all trials. Sustained virological response obtained with peginterferon plus ribavirin (55%) was significantly higher than with interferon plus ribavirin (30%) [relative risk, 1.71 (95% confidence interval, 1.15-2.56); P = 0.0088]. In the subgroup analyses, sustained virological response in trials using standard-dose ribavirin (1000 or 1200 mg/day) was 72% as against 45.8% in trials using low-dose ribavirin (800 mg/day) (P = 0.01). Further sub-group analyses for treatment duration, body weight, viral load and cirrhosis could not be performed because of lack of relevant data. CONCLUSION: Treatment-naive patients infected with hepatitis C virus genotype 4 should be treated with peginterferon plus standard-dose ribavirin for 1 year, with an expected sustained virological response rate of 72%.|Adult[MESH]|Antiviral Agents/*administration & dosage[MESH]|Drug Therapy, Combination[MESH]|Female[MESH]|Genotype[MESH]|Hepatitis C, Chronic/*drug therapy/genetics[MESH]|Humans[MESH]|Interferon alpha-2[MESH]|Interferon-alpha/*administration & dosage[MESH]|Male[MESH]|Middle Aged[MESH]|Polyethylene Glycols[MESH]|Prospective Studies[MESH]|Randomized Controlled Trials as Topic/standards[MESH]|Recombinant Proteins[MESH]|Ribavirin/administration & dosage/*therapeutic use[MESH]|Treatment Outcome[MESH] |