Background Triple therapy-based treatment with protease inhibitors in infected genotype 1 hepatitis C (HCV) patients improves efficacy measured as sustained virological response (SVR).
Purpose To compare the effectiveness and safety of triple therapy-based treatment in mono-infected and co-infected HCV-HIV patients.
Material and methods All treatments started between 2012/07/01 and 2013/12/31 were analysed. A retrospective evaluation was made of electronic medical records and outpatient pharmacy records. SVR was defined as undetectable viral load at week 60.
Results 83 patients were included, 80 treated with telaprevir and 3 with boceprevir, 58 mono-infected and 25 co-infected patients. Baseline characteristics in mono-infected patients were: 83% male, mean age 54 years; 26 genotype 1a, 30 1b, 2 untypable; 64% F4; 40% were treatment-naive, 14% relapsers, 12% partial responders, 31% null responders and 3% no data. In co-infected patients: 84% male, mean age 50 years; 17 genotype 1a, 71b, 1 untypable; 92% F4; 40% were treatment-naive, 28% relapsers, 12% partial responders, 12% null responders and 8% no data.
We were able to assess the effectiveness of treatment in 71 patients, who achieved 60 weeks of treatment: 51 mono-infected and 20 co-infected.
In the mono-infected group: 21 (41%) achieved SVR (86% treatment-naive or relapsers), 20 (39%) had a detectable viral load (50% null responders) (3 boceprevir-treated) and 10 (20%) discontinued treatment due to toxicity or disease progression. This compared with 11 (55%) (73% treatment-naive or relapsers), 8 (40%) (38% null responders) and 1 (5%) in the co-infected group.
Adverse events were: anaemia 58%, neutropenia 81% and thrombocytopenia 36% in mono-infected vs. 44%, 80% and 52% in co-infected patients.
Conclusion The rate of SVR was about 50%, higher in co-infected than in mono-infected HCV patients. However, it may have been affected by a greater proportion of null responders in the mono-infected group (p > 0.05), because as in published trials, the rates of SVR differed among patients with different responses to previous treatments.
References and/or Acknowledgements
Zeuzem S, Andreone P, Pol S, et al. Telaprevir for retreatment of HCV infection. N Engl J Med 2011;364:2417–28
Jacobson IM, McHutchison JG, Dusheiko G, et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med 2011;364:2405–16
References and/or AcknowledgementsNo conflict of interest.
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