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[Correspondence] New hepatitis C antiviral treatments eliminate the virus

The Cochrane Collaboration has published a topical systematic review1 and meta-analysis on direct-acting antivirals (DAA) for chronic hepatitis C virus (HCV) infection. Jakobsen and colleagues1 compared the results of randomised trials of any HCV DAA regimen versus no intervention or placebo. Their review reported data from 138 trials, which included 25 232 participants and encompassed all drugs on the market or under development. The authors confirm treatment has a significant benefit (relative risk 0·44, 95% CI 0·37–0·52, p<0·001), compared with no treatment, in the elimination of the virus from the bloodstream, measured 12–24 weeks after treatment (sustained virological response, SVR); however, they conclude there was “insufficient evidence to judge if DAAs have beneficial or harmful effects on other clinical outcomes for chronic HCV” and that although DAAs might increase SVR, “the clinical implication of the results on this non-validated surrogate outcome is unclear”.

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