title: Telaprevir can be successfully and safely used to treat older patients with genotype 1b chronic hepatitis C.
abstract: OBJECTIVE
  This study was performed to evaluate the efficacy of a triple therapy in older Japanese patients; telaprevir (TVR) was added to pegylated interferon α2b and ribavirin.
  
  
  METHODS
  This prospective study enrolled 120 genotype 1b patients with chronic hepatitis C who received 12 weeks of triple therapy followed by a 12-week dual therapy that included pegylated interferon α2b and ribavirin. Patients were categorized according to age: group A, 64 patients aged >60 and group B, 56 patients aged ⩽60. Serum HCV RNA levels were monitored by COBAS TaqMan HCV test.
  
  
  RESULTS
  The rates of undetectable HCV RNA at week 4 (rapid virological response, RVR) were 73.4% in group A and 73.2% in group B. No significant difference in sustained virological response (SVR) was found between groups A (76.6%) and B (83.9%) (p=0.314). The SVR rates for patients with interleukin 28B (IL28B) (rs8099917) TT allele (89.4% and 91.9% for groups A and B) were significantly higher than for those with the IL28B TG/GG allele (41.2% and 68.4%, respectively) (both p<0.05). Multivariate analysis extracted IL28B TT and RVR as independent factors associated with SVR. Adverse effects resulted in treatment discontinuation by 12.5% in each group. Hemoglobin decrease significantly differed between groups A and B: the decrease to ≤100 g/L, to 85 - <100g/L, and to <85 g/L, was 9.4%, 40.6%, and 50% in group A patients, respectively, and 41.1%, 25%, and 33.9% in group B patients, respectively (p=0.0006).
  
  
  CONCLUSIONS
  TVR-based triple therapy can be successfully used to treat older patients with genotype 1b chronic hepatitis C.
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Furusyo
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ogawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamuta
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajiwara
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nomura
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Dohmen
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Takeaki
authors.initials: T
authors.lastname: Satoh
authors.forename: Koichi
authors.initials: K
authors.lastname: Azuma
authors.forename: Akira
authors.initials: A
authors.lastname: Kawano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kotoh
authors.forename: Shinji
authors.initials: S
authors.lastname: Shimoda
authors.forename: Jun
authors.initials: J
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C417083:peginterferon alfa-2b
keywords: ALT; AST; Chronic hepatitis C; DAA; EOT; HCC; HCV; IL28B; ITPA; KULDS; NS3/4A; Older patients; PCR; PegIFN-α; Pegylated interferon α; RBV; RVR; Ribavirin; SNP; SVR; TVR; Telaprevir; The Kyushu University Liver Disease Study; alanine aminotransferase; aspartate aminotransferase; cEVR; complete early virological response; direct-acting antiviral agent; eGFR; end-of-treatment response; estimated glomerular filtration rate; hepatitis C virus; hepatocellular carcinoma; inosine triphosphate pyrophosphatase; interleukin 28B; non-structural 3/4A; pegylated interferon α; polymerase chain reaction; rapid virological response; ribavirin; single-nucleotide polymorphism; sustained virological response; telaprevir; γ-glutamyl-transpeptidase; γGTP