Background The use of protease inhibitors in the treatment of hepatitis C virus (HCV) infection has significantly increased the recovery rate.
Purpose To analyse the efficacy of triple therapy – telaprevir (TVP), peginterferon (P-IFN) and ribavirin (RBV) – as treatment for HCV genotype 1.
Material and methods Retrospective and observational study of patients who finished the triple therapy from September 2012 to January 2014.
The following data was gathered: age, sex, genotype, stage of hepatic fibrosis (FibroScan), frequencies of IL28B polymorphisms, response in case of pre-treatment, viral levels before starting treatment and 4, 12, 24 and 48 weeks afterwards (RT-PCR), as well as sustained virological response (SVR).
Data was obtained from the Electronic Clinical History (Jimena), Outcome Patients Program (Farmatools) and the laboratory program (Omega 3000 and 4000).
Results Of the 24 patients studied – 19 of whom were men – 2 were co-infected with HIV and another one with HBV. 33.33% of them were treatment-naïve, 25% null responders, 20.83% partial responders, 16.67% relapsers and 4.17% unknown. Genotypes 1a, 1b, 1c corresponded to 8, 9 and 1 patients respectively, 6 unknown. Hepatic fibrosis stage F4/F3/F2/F0–1 corresponded to 54.16%, 37.5%, 4.17% and 4.17% respectively. Two patients started the treatment with F < 3 because of several extrahepatic symptoms (MALT lymphoma and Porphyria Cutanea Tarda). IL28B polymorphisms were 50% CT, 33.33% CC, 12.5% TT and 4.16% not specified. The average viral load pre-treatment was 3,496,125 IU/ml (log = 6.54).
83.33% of patients achieved an undetectable viral load after 4 weeks, maintained after 12, 24 and 48 weeks, except for one patient. Two patients achieved viral suppression in the 12th week. The load did not decrease for the other two patients, therefore it was stopped. All of them improved, by at least one fibrosis stage.
Conclusion The introduction of TVP in HCV genotype 1 treatment increased the SVR rate for all patients, and was effective for 87.5% of them. There is a relationship between SVR and IL28B polymorphism, being 100% effective for CC patients and 80% for T allele carriers (CT and TT)
References and/or Acknowledgements No conflict of interest.
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