The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment) and by inconsistency and imprecise results.
A Cochrane review included 7 trials with a total of 1976 patients to assess the benefits and harms of interferon monotherapy retreatment in chronic hepatitis C patients.
The primary outcomes were mortality (all-cause and hepatic), quality of life, and adverse events. Patients with chronic hepatitis C who had failed prior antiviral therapy and who had severe histologic (grade 3 or 4 fibrosis demonstrated on liver biopsy) but compensated liver disease, were considered. Intervention was maintenance (usually half dose) pegylated interferon monotherapy for 3.5 and 5 years in outpatient setting. The main results are presented in Table 1.
| Outcome | Number of participants (studies) | Assumed risk (control) | Corresponding risk (interferon monotherapy) | Relative effect (95% CI) |
|---|---|---|---|---|
| All-cause mortality (5 years) | 1710 (3) | 72 per 1000 (high risk population) | 93 per 1000 (68 to 128) | RR 1.3 (0.95 to 1.79) |
| Liver-related mortality (5 years) | 1084 (2) | 72 per 1000 | 78 per 1000 (51 to 118) | RR 1.07 (0.7 to 1.63) |
| Variceal bleeding | 1710 (3) | 21 per 1000 | 5 per 1000 (2 to 15) | RR 0.26 (0.09 to 0.71) |
| Hepatic encephalopathy | 1676 (2) | 12 per 1000 | 11 per 1000 (4 to 27) | RR 0.92 (0.38 to 2.26) |
| Hepatocellular carcinoma | 1710 (3) | 62 per 1000 | 50 per 1000 (34 to 74) | RR 0.81 (0.55 to 1.19) |
| Serious adverse events | 1103 (2) | RR 1.02 (0.9 to 10.05) |
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