{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:14Z","timestamp":1792979894898,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    To assess the efficacy and safety of the Velpatasvir (VEL)\/Sofosbuvir (SOF) with or without Ribavirin (RBV) in treating patients with decompensated hepatitis C cirrhosis. We searched multiple databases for studies published from October 2010 to September 2024. Outcomes of interest were sustained viral response at 12\u2009weeks (SVR12) and the safety of VEL\/SOF with and without RBV regimens in patients with decompensated hepatitis C virus (HCV) cirrhosis. All statistical analyses were performed using R Statistics (4.4.1). We included 13 studies that enrolled 872 adult patients with decompensated cirrhosis due to HCV. The addition of RBV to the VEL\/SOF regimen neither significantly improved SVR12 after the last dose of treatment [95.0% (366\/391, 95% CI: 89.0\u201399.0) vs. 94.0% (442\/481, 95% CI: 90.0\u201397.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.92] nor decreased virologic relapse [1.0% (2\/158, 95% CI: 0.0\u20138.0) vs. 6.0% (12\/197, 95% CI: 3.0\u201310.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.15]. VEL\/SOF plus RBV therapy had a significantly higher rate of adverse events [92.0% (261\/287, 95% CI: 88.0\u201395.0) vs. 47.0% (167\/348, 95% CI: 24.0\u201371.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01] and death [7.0% (20\/287, 95% CI: 2.0\u201316.0) vs. 2.0% (8\/366, 95% CI: 1.0\u20134.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.05]. However, for patients with genotype 3, adding RBV to the VEL\/SOF regimen significantly improved SVR12 [87.0% (26\/30, 95% CI: 71.0\u201398.0) vs. 45% (7\/15, 95% CI: 13.0\u201379.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01] and decreased virologic relapse [0.0% (0\/10, 95% CI: 0.0\u201331.0) vs. 100% (1\/1, 95% CI: 2.0\u2013100.0);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02]. VEL\/SOF based therapy is a safe and effective treatment for patients with decompensated cirrhosis due to HCV. The addition of RBV to VEL\/SOF may increase toxicity without achieving improved efficacy overall. However, the addition of RBV significantly increased the SVR12 rate and reduced the virologic relapse in genotype 3 patients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    PROSPERO database: CRD42023491852\n                  <\/jats:p>","DOI":"10.1111\/jvh.70078","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T08:08:07Z","timestamp":1757405287000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy and Safety of Velpatasvir Plus Sofosbuvir With or Without Ribavirin in Hepatitis C Patients With Decompensated Cirrhosis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"32","author":[{"given":"Jing","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinnian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhou","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunhao","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-5971","authenticated-orcid":false,"given":"Yunjian","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30181-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27259"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70365-1"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2019.07.005"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.81a.13155"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27366"},{"issue":"2","key":"e_1_2_11_8_1","first-page":"90","article-title":"Frontiers in the Treatment of Hepatitis C Virus Infection","volume":"10","author":"Ahn J.","year":"2014","journal-title":"Gastroenterol Hepatology"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i21.3199"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.2013.775246"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12435"},{"issue":"1","key":"e_1_2_11_13_1","first-page":"144","article-title":"Efficacy and Safety of Sofosbuvir\u2010Based Regimens in Hepatitis C Patients With Decompensated Cirrhosis: A Systematic Review and Meta\u2010Analysis","volume":"11","author":"Zhang W.","year":"2023","journal-title":"Journal of Clinical and Translational Hepatology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-020-00329-y"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-021-00576-7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1512614"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15102026"},{"issue":"10","key":"e_1_2_11_18_1","first-page":"831","article-title":"Effectiveness and Safety of Sofosbuvir\/Velpatasvir Combination \u00b1 Ribavirin in the Treatment of Chinese Adults With Chronic Hepatitis C Virus Infection","volume":"28","author":"Li J. 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