title: Anti-viral triple therapy with telaprevir in haemodialysed HCV patients: is it feasible?
abstract: BACKGROUND
  Chronic hepatitis C virus (HCV) infection is the most common chronic liver disease in patients with end stage renal disease (ESRD) and is well known as a frequent cause of mortality and graft loss among haemodialysed and kidney transplant patients. Up to now, there are no data on antiviral efficacy and tolerability of available protease inhibitors (telaprevir and boceprevir) in HCV infected haemodialysed patients.
  
  
  METHODS
  We report 4 cases of HCV infected haemodialysed patients, who have not responded to a prior course of pegylated interferon (Peg-IFN) and ribavirin (RBV) and who were listed for kidney transplantation (KTx). These 4 patients received a second-line antiviral treatment with Peg-IFN, RBV and telaprevir.
  
  
  RESULTS
  After 12 weeks of triple therapy, tolerability was acceptable and HCV-RNA became undetectable in 3/4 patients. Mild side-effects included anaemia leading to increasing the doses of erythropoietin (EPO). Dose of RBV ranged from 200mg three times a week to 200mg/day.
  
  
  CONCLUSIONS
  Triple therapy with a first generation protease inhibitor could be the new standard for the treatment of HCV patients with ESRD. This needs to be confirmed by larger series.
authors.affiliation: Service de Gastroentérologie et Hépatologie, Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Lyon, France. jerome.dumortier@chu-lyon.fr
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
authors.forename: Olivier
authors.initials: O
authors.lastname: Guillaud
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Gagnieu
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Janbon
authors.forename: Laurent
authors.initials: L
authors.lastname: Juillard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
authors.forename: Vincent
authors.initials: V
authors.lastname: Leroy
mesh_terms: D000328:Adult; D000740:Anemia / Q000139:chemically induced; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; D012367:RNA, Viral; D012254:Ribavirin; C486464:telaprevir; D007372:Interferons