title: Sustained virological response after ten days of triple anti-hepatitis C virus (HCV) therapy with telaprevir plus pegylated interferon and ribavirin in an HIV/HCV co-infected cirrhotic woman.
abstract: The introduction of first-generation protease inhibitors for the treatment of chronic hepatitis C in subjects infected with hepatitis C virus (HCV) genotype 1 has significantly improved the sustained virological response (SVR) rate. As liver cirrhosis reduces the probability of achieving SVR, current guidelines discourage response-guided therapy in cirrhotic patients. We report the first case of a cirrhotic woman with chronic HCV and HIV co-infection achieving virological response after an ultra-short course of therapy. A 40-year-old HIV/HCV co-infected woman with compensated liver cirrhosis was treated with anti-HCV triple therapy containing telaprevir plus pegylated interferon and ribavirin. Baseline plasma HCV RNA was 3.6 log IU/ml and transaminases were within the normal range. She harboured IL28B rs12979860C/C alleles. Ten days after starting therapy, the patient stopped treatment because of mild anorexia and nausea. Virological response was detected at treatment discontinuation and was maintained up to 24 weeks. This case describes an unexpected SVR after a 10-day course of antiviral therapy in a cirrhotic HIV/HCV co-infected woman presenting positive predictive factors for a response (low viral load, IL28B genotype). Nonetheless, there is no evidence to suggest a shorter duration of treatment in this subset of patients.
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy. Electronic address: hasson.hamid@hsr.it.
authors.forename: Hamid
authors.initials: H
authors.lastname: Hasson
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Messina
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Merli
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: Liviana
authors.initials: L
authors.lastname: Della Torre
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Morsica
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Bagaglio
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Lazzarin
authors.affiliation: Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Uberti-Foppa
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications*; D009842:Oligopeptides / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; D011480:Protease Inhibitors; D012367:RNA, Viral; D012254:Ribavirin; C486464:telaprevir; D007372:Interferons
keywords: HIV/HCV co-infection; Liver cirrhosis; Telaprevir