Cochrane · systematic review · CD007003
Interventions for dialysis patients with hepatitis C virus (HCV) infection
Prabhu, AR, Rao, IR, Nagaraju, SP, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
50
current version
GRADE rated
30
No studies
20
Included studies
NR
No studies 20 · 40%Ungraded 0 · 0%Very low 2 · 4%Low 22 · 44%Moderate 6 · 12%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyStandard interferon versus placebo or control for haemodialysis patients with hepatitis C virus infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Standard interferon vs placebo or control | RR 0.89 [0.06, 13.23] | 5 studies · 134 participants | Low |
Relapse(recurrence after stopping intervention) Standard interferon vs placebo or control | RR 0.72 [0.28, 1.88] | 1 study · 12 participants | Low Downgraded: imprecision |
End‐of‐treatment response Standard interferon vs placebo or control | RR 8.62 [3.03, 24.55] | 5 studies · 132 participants | Moderate |
Sustained virological response 6 months after stopping treatment Standard interferon vs placebo or control | RR 3.25 [0.81, 13.07] | 4 studies · 98 participants | Moderate |
Treatment discontinuation Standard interferon vs placebo or control | RR 4.59 [0.49, 42.69] | 4 studies · 116 participants | Moderate |
Adverse events Standard interferon vs placebo or control | RR 3.56 [0.98, 13.01] | 5 studies · 143 participants | Moderate |
Pegylated interferon alpha‐2a versus standard interferon for haemodialysis patients with hepatitis C virus infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Pegylated interferon alpha‐2a vs standard interferon | RR 0.33 [0.01, 7.81] | 1 study · 50 participants | Low |
Relapse(recurrence after stopping) Pegylated interferon alpha‐2a vs standard interferon | RR 0.72 [0.41, 1.25] | 1 study · 38 participants | Low |
End‐of‐treatment response Pegylated interferon alpha‐2a vs standard interferon | RR 1.53 [1.09, 2.15] | 1 study · 50 participants | Low |
Sustained virological response 6 months after stopping treatment Pegylated interferon alpha‐2a vs standard interferon | RR 2.4 [0.99, 5.81] | 1 study · 50 participants | Low |
Treatment discontinuation Pegylated interferon alpha‐2a vs standard interferon | RR 0.11 [0.01, 1.96] | 1 study · 50 participants | Low |
Adverse events Pegylated interferon alpha‐2a vs standard interferon | RR 0.11 [0.01, 1.96] | 1 study · 50 participants | Low |
High versus low dose pegylated interferon alpha‐2a or alpha‐2b for haemodialysis patients with hepatitis C virus infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death High vs low dose pegylated interferon alpha‐2a or alpha‐2b | no estimate extracted | NR | No studies |
PEG interferon alpha‐2a High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 5.66 [0.69, 46.31] | 1 study · 81 participants | Low Downgraded: imprecision |
PEG interferon alpha‐2b High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 2.4 [0.11, 51.32] | 1 study · 16 participants | Low Downgraded: imprecision |
PEG interferon (combined) High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 4.3 [0.76, 24.33] | 2 studies · 97 participants | Moderate Downgraded: imprecision |
PEG interferon alpha‐2a High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 1.12 [0.4, 2.21] | 1 study · 43 participants | Low Downgraded: imprecision |
PEG interferon (combined) High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 1.12 [0.4, 2.21] | 1 study · 43 participants | Low Downgraded: imprecision |
End‐of‐treatment response High vs low dose pegylated interferon alpha‐2a or alpha‐2b | no estimate extracted | NR | No studies |
PEG interferon alpha‐2a High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 1.19 [0.79, 1.78] | 1 study · 81 participants | Low Downgraded: imprecision |
PEG interferon (alpha‐2b) High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 5.6 [0.34, 93.35] | 1 study · 16 participants | Low Downgraded: imprecision |
PEG interferon alpha‐2a High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 1.13 [0.64, 2] | 1 study · 81 participants | Low Downgraded: imprecision |
Treatment discontinuation High vs low dose pegylated interferon alpha‐2a or alpha‐2b | no estimate extracted | NR | No studies |
Adverse events High vs low dose pegylated interferon alpha‐2a or alpha‐2b | no estimate extracted | NR | No studies |
PEG interferon (combined) High vs low dose pegylated interferon alpha‐2a or alpha‐2b | RR 1.05 [0.61, 1.83] | 2 studies · 97 participants | Moderate Downgraded: risk of bias, imprecision |
Serious adverse events High vs low dose pegylated interferon alpha‐2a or alpha‐2b | no estimate extracted | NR | No studies |
Standard interferon plus ribavirin versus standard interferon alone for haemodialysis patients with hepatitis C virus infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Standard interferon plus ribavirin vs standard interferon alone | no estimate extracted | NR | No studies |
Relapse(recurrence after stopping) Standard interferon plus ribavirin vs standard interferon alone | no estimate extracted | NR | No studies |
End‐of‐treatment response Standard interferon plus ribavirin vs standard interferon alone | no estimate extracted | NR | No studies |
Sustained virological response Standard interferon plus ribavirin vs standard interferon alone | no estimate extracted | NR | No studies |
Treatment discontinuation Standard interferon plus ribavirin vs standard interferon alone | RR 2.97 [1.19, 7.36] | 1 study · 52 participants | Low Downgraded: imprecision |
Adverse events Standard interferon plus ribavirin vs standard interferon alone | no estimate extracted | NR | No studies |
Pegylated interferon plus ribavirin versus pegylated interferon alone for haemodialysis patients with hepatitis C infection
Population: HD patients with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Pegylated interferon plus ribavirin vs pegylated interferon alone | no estimate extracted | NR | No studies |
Relapse(recurrence after stopping) Pegylated interferon plus ribavirin vs pegylated interferon alone | RR 0.33 [0.23, 0.48] | 1 study · 377 participants | Low |
End‐of‐treatment response Pegylated interferon plus ribavirin vs pegylated interferon alone | RR 1.01 [0.94, 1.09] | 1 study · 377 participants | Low |
Sustained virological response Pegylated interferon plus ribavirin vs pegylated interferon alone | RR 1.8 [1.46, 2.21] | 1 study · 377 participants | Low Downgraded: risk of bias, imprecision |
Treatment discontinuation Pegylated interferon plus ribavirin vs pegylated interferon alone | RR 1.71 [0.69, 4.24] | 1 study · 377 participants | Low |
Adverse events Pegylated interferon plus ribavirin vs pegylated interferon alone | RR 1.1 [1.01, 1.19] | 1 study · 377 participants | Low Downgraded: risk of bias, imprecision |
Direct antivirals (grazoprevir and elbasvir) versus placebo for haemodialysis patients with hepatitis C infection
Population: HD patients with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Direct antivirals (grazoprevir and elbasvir) vs placebo | no estimate extracted | NR | No studies |
Relapse Direct antivirals (grazoprevir and elbasvir) vs placebo | no estimate extracted | NR | No studies |
End‐of‐treatment response Direct antivirals (grazoprevir and elbasvir) vs placebo | RR 174.99 [11.03, 2775.78] | 1 study · 173 participants | Low |
Sustained virological response Direct antivirals (grazoprevir and elbasvir) vs placebo | no estimate extracted | NR | No studies |
Treatment discontinuation Direct antivirals (grazoprevir and elbasvir) vs placebo | no estimate extracted | NR | No studies |
Adverse events Direct antivirals (grazoprevir and elbasvir) vs placebo | no estimate extracted | NR | No studies |
Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) versus pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) for haemodialysis patients with hepatitis C infection
Population: HD patients with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | no estimate extracted | NR | No studies |
Relapse Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | no estimate extracted | NR | No studies |
Sustained virological response Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | RR 1.02 [0.67, 1.56] | 1 study · 35 participants | Very low Downgraded: risk of bias |
End‐of‐treatment response Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | RR 1.02 [0.67, 1.56] | 1 study · 35 participants | Very low Downgraded: risk of bias |
Treatment discontinuation Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | no estimate extracted | NR | No studies |
Adverse events Pegylated interferon + ribavirin (24 weeks) + initial telepravir (12 weeks) vs pegylated interferon (48 weeks) + initial telepravir (12 weeks) + initial low dose ribavirin (12 + 36 weeks) | no estimate extracted | NR | No studies |
Standard interferon versus placebo/control for haemodialysis (HD) patients with hepatitis C virus (HCV) infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Number of deaths at maximum Standard interferon vs placebo/control | RR 0.89 [0.06, 13.23] | 51 studies · 134 participants | Low Downgraded: risk of bias |
Relapse Number of participants having recurrence after stopping the intervention Standard interferon vs placebo/control | RR 0.72 [0.28, 1.88] | 1 study · 12 participants | Moderate |
End of treatment response Number of participants responding to treatment at the end of treatment Standard interferon vs placebo/control | RR 8.62 [3.03, 24.55] | 5 studies · 132 participants | Moderate |
Sustained virological response Number of participants having a sustained response 6 months after stopping the treatment Standard interferon vs placebo/control | RR 3.25 [0.81, 13.07] | 4 studies · 98 participants | Moderate |
Treatment discontinuation Number of participants discontinuing treatment Standard interferon vs placebo/control | RR 4.59 [0.49, 42.69] | 4 studies · 116 participants | Moderate |
Number of participants with adverse events Total number of participants with adverse events in each group Standard interferon vs placebo/control | RR 3.56 [0.98, 13.01] | 5 studies · 143 participants | Moderate |
Pegylated (PEG) interferon alpha‐2a versus standard interferon for haemodialysis (HD) patients with hepatitis C virus (HCV) infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Number of deaths at maximum Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 1.04 [0.93, 1.16] | 1 study · 50 participants | Moderate |
Relapse Number of participants having recurrence after stopping Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 0.72 [0.41, 1.25] | 1 study · 38 participants | Moderate |
End of treatment response Number of participants responding to treatment at the end of treatment Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 1.53 [1.09, 2.15] | 1 study · 50 participants | Moderate |
Sustained virological response Number of participants having a sustained response 6 months after stopping the treatment Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 2.4 [0.99, 5.81] | 1 study · 50 participants | Moderate |
Treatment discontinuation Number of participants discontinuing treatment Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 1.19 [0.99, 1.43] | 1 study · 50 participants | Moderate |
Number of participants having adverse events Number of participants with adverse events Pegylated (PEG) interferon alpha‐2a vs standard interferon | RR 2.25 [0.12, 40.65] | 1 study · 50 participants | Moderate |
Number of events is low Pegylated (PEG) interferon alpha‐2a vs standard interferon | no estimate extracted | 1 participants | Low |
High versus low dose pegylated (PEG) interferon alpha‐2a for haemodialysis (HD) patients with hepatitis C virus (HCV) infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Number of deaths at maximum High vs low dose pegylated (PEG) interferon alpha‐2a | RR 5.66 [0.69, 46.31] | 1 study · 81 participants | Moderate |
Relapse Number of participants having recurrence after stopping High vs low dose pegylated (PEG) interferon alpha‐2a | RR 1.12 [0.4, 2.21] | 1 study · 43 participants | Moderate Downgraded: imprecision |
End of treatment response Number of participants responding to treatment at the end of treatment High vs low dose pegylated (PEG) interferon alpha‐2a | RR 1.19 [0.79, 1.78] | 1 study · 81 participants | Moderate |
Sustained virological response Number of participants having a sustained response 6 months after stopping the treatment High vs low dose pegylated (PEG) interferon alpha‐2a | RR 1.13 [0.64, 2] | 1 study · 81 participants | Moderate |
Treatment discontinuation Number of participants discontinuing treatment High vs low dose pegylated (PEG) interferon alpha‐2a | RR 1.03 [0.49, 2.15] | 1 study · 81 participants | Moderate |
Number of participants with adverse events Total number of participants with adverse events in each group High vs low dose pegylated (PEG) interferon alpha‐2a | RR 0.95 [0.78, 1.15] | 1 study · 81 participants | Moderate |
Number of participants with serious adverse events Total number of participants with serious adverse events High vs low dose pegylated (PEG) interferon alpha‐2a | RR 1.13 [0.62, 2.06] | 1 study · 81 participants | Moderate |
High versus low dose pegylated (PEG) interferon alpha‐2b for haemodialysis (HD) patients with hepatitis C virus (HCV) infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Number of deaths at maximum High vs low dose pegylated (PEG) interferon alpha‐2b | RR 2.4 [0.11, 51.32] | 1 study · 16 participants | Moderate |
Relapse Number of participants having recurrence after stopping High vs low dose pegylated (PEG) interferon alpha‐2b | no estimate extracted | 1 study · 3 participants | Ungraded |
End of treatment response Number of participants responding to treatment at the end of treatment High vs low dose pegylated (PEG) interferon alpha‐2b | RR 5.6 [0.34, 93.35] | 1 study · 16 participants | Moderate |
Sustained virological response Number of participants having a sustained response 6 months after stopping the treatment High vs low dose pegylated (PEG) interferon alpha‐2b | RR 4 [0.22, 72.01] | 1 study · 16 participants | Moderate |
Treatment discontinuation Number of participants discontinuing treatment High vs low dose pegylated (PEG) interferon alpha‐2b | RR 1.94 [0.53, 7.2] | 1 study · 16 participants | Moderate |
Number of participants with adverse events Total number of participants with adverse events in each group High vs low dose pegylated (PEG) interferon alpha‐2b | RR 1.94 [0.53, 7.2] | 1 study · 16 participants | Moderate |
Number of participants with serious adverse events‐ Total number of participants with serious adverse events in each group High vs low dose pegylated (PEG) interferon alpha‐2b | RR 1.94 [0.53, 7.2] | 1 study · 16 participants | Moderate |
Standard Interferon compared to standard interferon with ribavirin for dialysis patients with hepatitis C virus (HCV) infection
Population: patients on HD with HCV infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment discontinuation Number of patients discontinuing treatment Standard Interferon vs standard interferon with ribavirin | RR 0.34 [0.14, 0.84] | 1 study · 54 participants | Moderate |