Very short course of triple therapy including telaprevir for chronic hepatitis C: a possible strategy in selected patients.
The recent introduction of direct antiviral agents (DAAs) as a fundamental part of anti-hepatitis C virus (HCV) therapy has dramatically improved the possibility of cure for patients with genotype 1, but at the same time has increased the incidence of severe adverse events and the risk of reduced compliance. Here we present the case of a 72-year-old Caucasian male suffering from a genotype 1b HCV infection, with a previous history of virological breakthrough at the end of dual therapy with pegylated interferon and ribavirin at standard dosages. The patient was retreated with telaprevir-based triple therapy, and despite the early spontaneous interruption of treatment because of severe anemia and fatigue, he obtained a sustained virological response. This case suggests that in selected genotype 1 HCV-infected patients, primarily of subtype 1b, who require the interruption of anti-HCV therapy because of severe adverse events or reduced compliance, a successful treatment can be obtained even with a very short course of DAA-based triple therapy.
Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Largo Brambilla 3, I-50134 Florence, Italy. Electronic address: giampaolo.corti@unifi.it.
Giampaolo
G
Corti
Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Largo Brambilla 3, I-50134 Florence, Italy.
Elena
E
Salomoni
Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Largo Brambilla 3, I-50134 Florence, Italy.
Filippo
F
Baragli
D000284:Administration, Oral; D000368:Aged; D000740:Anemia / Q000139:chemically induced; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007279:Injections, Subcutaneous; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009842:Oligopeptides / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha; D009842:Oligopeptides; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C100416:peginterferon alfa-2a
Anemia; Direct antiviral agents; Hepatitis C virus; Pegylated interferon; Ribavirin; Telaprevir