title: Telaprevir in the treatment of acute hepatitis C virus infection in HIV-infected men.
abstract: BACKGROUND
  There is an international epidemic of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected men who have sex with men. Sustained virologic response (SVR) rates with pegylated interferon and ribavirin treatment are higher in these men during acute HCV than during chronic HCV, but treatment is still lengthy and SVR rates are suboptimal.
  
  
  METHODS
  We performed a pilot study of combination therapy with telaprevir, pegylated interferon, and ribavirin in acute genotype 1 HCV infection in HIV-infected men. Men who were treated prior to the availability of, or ineligible for, telaprevir were the comparator group. The primary endpoint was SVR12, defined as an HCV viral load <5 IU/mL at least 12 weeks after completing treatment.
  
  
  RESULTS
  In the telaprevir group, 84% (16/19) of men achieved SVR12 vs 63% (30/48) in the comparator group. Among men with SVR, median time to undetectable viral load was week 2 in the telaprevir group vs week 4 in the comparator group, and 94% vs 53% had undetectable viral loads at week 4. Most patients (81%) who achieved SVR in the telaprevir group received ≤12 weeks of treatment and there were no relapses after treatment. The overall safety profile was similar to that known for telaprevir-based regimens.
  
  
  CONCLUSIONS
  Incorporating telaprevir into treatment of acute genotype 1 HCV in HIV-infected men halved the treatment duration and increased the SVR rate. Larger studies should be done to confirm these findings. Clinicians should be alert to detect acute HCV infection of HIV-infected men to take advantage of this effective therapy and decrease further transmission in this epidemic.
authors: Divisions of Infectious Diseases.
authors: Daniel S
authors: DS
authors: Fierer
authors: Douglas T
authors: DT
authors: Dieterich
authors: Michael P
authors: MP
authors: Mullen
authors: Andrea D
authors: AD
authors: Branch
authors: Alison J
authors: AJ
authors: Uriel
authors: Damaris C
authors: DC
authors: Carriero
authors: Wouter O
authors: WO
authors: van Seggelen
authors: Rosanne M
authors: RM
authors: Hijdra
authors: David G
authors: DG
authors: Cassagnol
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000821:virology*; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D010865:Pilot Projects
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; C486464:telaprevir
keywords: HIV infection; acute HCV; men who have sex with men; telaprevir; treatment