Analysis of Safety Outcomes in Chronic Hepatitis C Patients using Interferon-free Treatment: A Systematic Review of Case Reports

Background: Second generation direct acting-antivirals are safe and effective treatments for chronic hepatitis C patients. Objective: We aimed to conduct a systematic review of case reports and case series to evaluate the safety of the drugs, highlighting a compilation of AE not previously reported in other reviews. Methods: The search was performed in four electronic databases and included only case reports and case series that evaluated interferon-free therapies and provided safety outcomes. Results: Initially 1,235 records were retrieved, and after screening 30 studies were included in the analysis (23 case reports and 7 case series). A total of 39 patients were included, receiving eight different interferon-free treatments. Nineteen patients discontinued treatment (only 8 of these achieved treatment response). Other 19 patients achieved SVR without discontinuation. Rare adverse events were observed, including breast hypertrophy, retinopathy and drug-induced infection. Some patients were in an advanced stage of the disease, and were therefore unable to withstand treatment due to the appearance of complications. Conclusion: In this sense, it is important to monitor the use of these drugs that can favor the appearance of serious AE. (PROSPERO registration number CRD42016051680).