What is expected from the novel triple combination antiviral treatment of patients infected with hepatitis C virus genotype 1?

Abstract

Since May 2011, protease inhibitor/ribavirin/peginterferon combination has become the standard treatment for both treatment-naive and treatment-experienced patients infected with hepatitis C virus genotype 1. In Hungary, due to limited resources, the therapy of treatment-experienced patients might only be financed in the near future. The aim of this retrospective study was to find out characteristics of the patient group waiting for new triple combination in a single hepatology centre in Hungary, and to estimate the possible rate of their sustained virologic response. Between January 2004 and September 2012, 269 patients with chronic hepatitis C virus infection were treated with peginterferon/ribavirin therapy. 142 patients failed to achieve sustained virologic response, but out of them, 93 individuals are the possible candidates for the triple antiviral treatment. In the latter group, the previous virologic response to dual therapy was determined. To register fibrosis scores, findings of liver biopsy and/or fibroelastography were also collected. Interleukin28B genotypes of 49 patients were determined. Among the 93 treatment-experienced patients, 25 relapsed, 26 responded partially , 6 broke through, and 36 null-responders were found. 29% of patients had mild or moderate fibrosis and 71% of those already had severe fibrosis. Of the 49 patients with known interleukin28B genotype only 8 patients had the CC genotype. About half of the patients (mostly relapsers, and some partial responders as well) have a good chance of achieving sustained virologic response, which may be influenced by the fibrosis score.