Efficacy and safety of sofosbuvir-based interferon-free therapies for hepatitis C in liver transplant recipients

Background and Aim: The aim of this study is to assess the efficacy and safety of sofosbuvir-based interferon-free therapies in liver transplantation recipients with hepatitis C virus infection recurrence. Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and CENTRAL on the Cochrane Library without time or language limitation. The search strategy used was "sofosbuvir AND transplantation." Sustained virologic response at 12 weeks after the end of treatment (SVR12) rate, incidence of serious adverse events (SAEs) and/or adverse events, discontinuation rate with 95% confidence intervals (CI) were pooled with random-effects model. Results: Twenty-two studies (1730 patients) were included for our meta-analysis. The pooled SVR12 rate was 90.1% ( 95% CI 86.4-93.4%, I-2 = 81.6%). SVR12 rate was higher in patients with mild fibrosis than in patients with advanced fibrosis and cirrhosis (RR = 1.072, 95% CI 1.031-1.115, I-2 = 3.6%). For patients with hepatitis C virus genotype 1, the pooled SVR12 rate was 91.9% ( 95% CI 89.2-94.2%, I-2 = 53.3%). The pooled SAEs incidence was 8.3% ( 95% CI 5.6-11.5%, I-2 = 78.4%). The pooled discontinuation rate because of adverse events or SAEs was 3.3% ( 95% CI 1.8-5.2%). Conclusions: Sofosbuvir-based interferon-free therapy is an effective and well-tolerated treatment strategy for patients with hepatitis C virus infection recurrence after liver transplantation.