Efficacy And Safety Of Sofosbuvir Plus Daclatasvir With And Without Ribavirin In Patients With Genotype 3 Chronic Hepatitis C:A Meta-analysis

Background:Direct-acting antiviral drugs(DAAs)are currently in favor of the treatment of hepatitis C virus(HCV)infection.The treatment effection of Sofafivir)(SOF)plus dacarbavir(DCV)in patients with genotype 3 chronic hepatitis C virus infection with or without ribavirin(RBV)is approved.Objective:This article aims to scientifically summarize and evaluate the efficacy and safety of Sofibuvir(SOF)plus dacarbavir(DCV)with or without ribavirin(RBV)in the treatment of genotype 3(GT3)chronic hepatitis C patients by mete-analysis.Method:we seriously search databases include PubMed,EMBASE,Cochrane Library,EBSCO,clinical trials databases,China Knowledge Network,Wanfang Medical,and China Biomedical Literature by Computer.The search terms are:"sofosbuvir","PSI 7977","7977,PSI",""PSI7977","PSI-7977","GS-7977","Sovaldi","Daklinza","daclatasvir"、"Hepatitis C,Chronic","Chronic Hepatitis C","Ribavirin".The language is not limited,and the research object is human.According to the search strategy combining keyword+free word,we collect Sofibuvir(SOF)plus dacarbavir(DCV)with or without ribavirin(RBV)in the treatment of genotype3(GT3)chronic hepatitis C patients between January 2012 and January 2018.A randomized,controlled study of the treatment of chronic hepatitis C in type 3 patients.we selected literatures,evaluated quality of methodology and extracted dates according to the established inclusion and exclusion criteria.Then,We analyzed relevant dates by Rev Man 5.3 software for meta-analysis.Based on the heterogeneity test I~2 value,select a meta-analysis of the fixed effect model or the random effect model.The primary outcome measures included the sustained virological response rate(SVR12:no detectable HCV-RNA at least 12 weeks after treatment endpoint)and adverse event rate at 12 weeks after the end of treatment.Results:Totally,seven studies were included synthetically in the present Meta-analysis.The total number of SOF+DCV(SD)group were 10591And SOF+DCV+RBV(SDR)group were 8548.Meta analysis results show:1.There was no statistically significant difference in SVR12 between SOF+DCVgroupandSOF+DCV+RBVgroup(RR=1.01,95%Cl1.00~1.01,P=0.03).2.bysubgroupanalysis,SVR12inSOF+DCV+RBVgroupwasnohigherthanSOF+DCVgroupfor12-weektreatment(RR=0.93,95%Cl0.80~1.08,P=0.34);for24-weektreat ment(RR=1.04,95%Cl0.82~1.33,P=0.73).3.Compared with SOF+DCVgroup,The incidence of adverse reactions in the SOF+DCV+RBV group was significantly higher than that in the SOF+DCV group(RR=0.43,95%Cl0.34~0.55,P<0.00001).4.There was no statistically significant difference in discontiution treatment due to adverse between SOF+DCV group and SOF+DCV+RBV group(RR=0.67,95%Cl0.34~1.34,P=0.26).5.There was no statistically significant difference in replase between SOF+DCV group and SOF+DCV+RBV group(RR=0.94,95%Cl0.73~1.22,P=0.66).Conclusion:Meta-results showed that the efficacy of SOF+DCV+RBV group in treating patients with genotype 3 chronic hepatitis C was not inferior to that of SOF+DCVgroup,and the efficacy was similar at different treatment times.but,the adverse rate in SOF+DCV+RBV group was inferior to SOF+DCVgroup.