Nine controlled trials were included (n=619): six RCTs (n= 394) and three non randomised studies (n=225).
Liver transplant candidates (two RCTs and one non randomised study, n=335): The RCTs scored 5 and 3 out of 5 for quality. Mean sustained virological response rates were 30% (range 19.6% to 50%) for group A treatment arms (Peg/800 to 1,200mg R, n=181) compared with 16% (range 0% to 38%) for group B treatment arms (Peg/low-dose R, no treatment or Peg monotherapy, n=174). One RCT reported no significant difference in discontinuation rates between Peg/R and Peg alone; the statistical significance of treatment differences in other studies was not reported. Two studies reported mortality, but the statistical significance of treatment differences were not reported.
Treatment for recurrent HCV disease post transplant (four RCTs and two non-randomised studies, n=264): The two RCTs published as full reports scored 3 and 4 out of 5 for quality. Mean sustained virological response were 41% (range 30% to 78%) for group A treatment arms (Peg/800 to 1,200mg R, n=140) compared with 9% (range 0% to 50%) for group B treatment arms (Peg/low-dose R, no treatment or Peg monotherapy, n=124).
Peg/800 to 1,200 mg R was associated with a statistically significant increase in sustained virological response compared to control treatments (absolute risk difference 0.31, 95% CI 0.18 to 0.44, p<0.001). Significant heterogeneity was found (p=0.058, I2=59%).
There was no significant difference between Peg/800 to 1,200 mg R versus no treatment or other regimen treatments in histological response (significant heterogeneity was found, I2=94%), discontinuation of treatment, acute or chronic rejection or mortality.
The funnel plot showed no evidence of publication bias for recurrent HCV patients (p=0.08 for test of asymmetry).