Maintenance interferon therapy in chronic hepatitis C patients who failed initial antiviral therapy A meta-analysis

Objectives: To evaluate the effect of pegylated interferon maintenance therapy in patients with chronic hepatitis C who failed initial antiviral therapy. Methods: This is a meta-analysis of 6 randomized controlled trials that met the eligibility criteria. In all, 2438 chronic hepatitis C patients who failed to achieve sustained virologic response after initial treatment with pegylated interferon and ribavirin (antiviral therapy nonresponders or relapsers) were enrolled; 1237 patients received maintenance therapy (Maintenance group) and 1201 received no treatment (Observation group). Results: The pooled analyses found that patients in the Maintenance group had a significantly higher rate of normal alanine aminotransferase than did patients in the Observation group (pooled odds ratio [OR] 4.436, 95% confidence interval [CI] 1.225–16.064, P = .023), but there was no significant difference between the 2 groups in the incidence of hepatocellular carcinoma (pooled OR 0.872, 95% CI 0.501–1.519, P = .630), or the mortality rate (pooled OR 1.564, 95% CI 0.807–3.032, P = .185). Conclusions: Interferon-based maintenance therapy in patients with chronic hepatitis C who failed initial antiviral therapy improved liver inflammation as indicated by blood chemistry (alanine aminotransferase). Abbreviations: ALT = alanine aminotransferase, CHC = chronic hepatitis C, CIs = confidence intervals, DAA = direct-acting antivirals, HALT-C = hepatitis C antiviral long-term treatment against cirrhosis, HCC = hepatocellular carcinoma, HCV = hepatitis C virus, I2 = inconsistency index, OR = odds ratio, Peg-interferon = pegylated interferon, RCTs = randomized controlled trials, SVR = sustained virologic response.