Telaprevir combination therapy in patients infected with hepatitis C virus genotype 4

Abstract

Background: The sustained virological response (SVR) rate for genotype 4 (G4) HCV-infected patients after pegylated interferon (PegIFN) and ribavirin (RBV) treatment is approximately 60%. We aimed to investigate the efficacy and safety of telaprevir (TVR) in combination with PegIFN and RBV in patients infected with G4 HCV who were previously treated with PegIFN/RBV and failed to achieve SVR. Material and Methods: The study included 10 patients: two prior relapsers, two prior partial responders, and six prior null responders to PegIFN/RBV treatment. The patients were given TVR/PegIFN/RBV for 12 weeks, followed by a 12-36 weeks PegIFN/RBV treatment. Rapid virological response (RVR), early virological response (EVR), extended rapid virological response (eRVR), SVR, and side effects of therapy were evaluated. Results: The mean age of the patients was 48.90±12.52 years and seven were female. All of HCV isolates were typed as 4d. Interleukin (IL) 28B genotype was found CT in seven patients and two patients had cirrhosis. Treatment was stopped within four weeks because of the side effects in two patients. Three of the remaining eight patients (37.5%) achived HVR, RVR, and eHVR. SVR was obtained in two of these patients, but one patient relapsed. SVR rates were 25% in all patients. Conclusion: TVR combination therapy had limited antiviral activity in this patient population. Further investigation of TVR combination therapy in patients with HCV G4 infection is warranted.