Evidence map›Paper›PMID 25755563›Full record

ArticleJournal of clinical and experimental hepatology2014

Hepatitis C virus treatment in the 'real-world': how well do 'real' patients respond?

N Deborah Friedman, Joanne H Green, Hanna M Weber, Shiny Stephen, Stephen E Lane, Alvin Y Ting, Jonathan P Watson

Abstract read
In one paragraph

Article in Journal of clinical and experimental hepatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa.Journal of clinical and experimental hepatology · 2018
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

N Deborah FriedmanDepartment of Infectious Diseases, Geelong, Victoria, Australia ; Department of Medicine, Geelong, Victoria, Australia.
Joanne H GreenDeakin University School of Medicine, Geelong, Victoria, Australia.
Hanna M WeberDeakin University School of Medicine, Geelong, Victoria, Australia.
Shiny StephenDeakin University School of Medicine, Geelong, Victoria, Australia.
Stephen E LaneDepartment of Medicine, Geelong, Victoria, Australia ; Deakin University School of Medicine, Geelong, Victoria, Australia.
Alvin Y TingDepartment of Gastroenterology, Barwon Health, Geelong, Victoria, Australia.
Jonathan P WatsonDepartment of Medicine, Geelong, Victoria, Australia ; Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia ; Deakin University School of Medicine, Geelong, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPublished clinical trials of the treatment of HCV are largely multicentre prospective pharmaceutical trials. Patients in clinical trials tend to have more favorable outcomes than patients in the 'real-world', due to strict patient selection and differences in treatment conditions and available resources.

objectivesTo assess the outcomes of Hepatitis C infected patients treated at the Barwon Health Liver Clinic with combination Pegylated interferon (PEG-IFN) and Ribavirin (RBV) therapy and to determine factors associated with a treatment response.

methodsRetrospective review of patients who received treatment for Hepatitis C at our institution's Liver Clinic from January 2001-September 2011. Patient demographics, comorbidities, treatment-related parameters and side effects were extracted from medical records and analyzed.

resultsA total of 190 patients (120 male, 70 female) with a mean age of 42.8 years (range 20-68 years) commenced treatment. The most common genotype was genotype 3 (48.9%), followed by genotype 1 (42.6%). 150 of 190 patients (78.9%) completed treatment and had end of treatment data available. 107 of 182 patients, (58.8%) for whom sustained virologic response (SVR) rate data was available achieved an SVR. Overall response rates were; 46.9%, 68.8% and 62.4% in genotypes 1, 2 and 3 respectively. The response rate was significantly lower in 29 patients with documented cirrhosis (20.7%). Age, diabetes and alcohol abuse did not predict treatment response in our cohort. Side effects reported in 81.6% of patients included general malaise, hematological disturbance and psychiatric issues, and necessitated cessation of therapy in 16 patients (8.4%) and dose reduction in 26 patients (13.7%).

conclusionsResponse rates to combination PEG-IFN and RBV therapy at our institution are comparable to other 'real-world' and pharmaceutical registration trials. Side effects of combination therapy were prominent but resulted in fewer discontinuations of therapy compared to pharmaceutical trials.

Indexed as

DAAs, directly acting agentsETR, end of treatment responseHCV, hepatitis C virushepatitis CIVDU, intravenous drug useNSW, new South WalesPCR, polymerase chain reactionPEG-IFN, pegylated interferonpeginterferon alfa-2apeginterferon alfa-2bRBV, ribavirinribavirinRNA, ribonucleic acidSVR, sustained virologic response

Identifiers

PMID25755563
PMCPMC4284209

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.