title: Boceprevir-Based Triple Antiviral Therapy for Chronic Hepatitis C Virus Infection in Kidney-Transplant Candidates.
abstract: Background. There are few data on the combination of (pegylated-) interferon- (Peg-IFN-) α, ribavirin, and first-generation direct-acting antiviral agents (DAAs). Our aim was to describe the efficacy and safety of Peg-IFN-α, ribavirin, and boceprevir in hemodialysis patients. Patients. Six hemodialysis patients, chronically infected by genotype-1 HCV, were given Peg-IFN-α (135 µg/week), ribavirin (200 mg/d), and boceprevir (2400 mg/d) for 48 weeks. Results. At initiation of antiviral therapy, median viral concentration was 5.68 (3.78-6.55) log IU/mL. HCV RNA was undetectable in four of the six patients at week 4 and in all patients at week 24. A breakthrough was observed in two patients between weeks 24 and 48, and a third patient stopped antiviral therapy between weeks 24 and 48 because of severe peripheral neuropathy. At week 48, HCV RNA was undetectable in three patients. Of these, two patients relapsed within a month after antiviral therapy was stopped. Hence, only one patient had a sustained virological response; he was a previous partial responder. Overall, anemia was the main side effect. Conclusion. A triple antiviral therapy based on Peg-IFN-α, ribavirin, and boceprevir is not optimal at treating hemodialysis patients with chronic HCV infection. Studies using new-generation drugs are required in this setting.
authors.affiliation: Faculty of Medical Science, Lebanese University, Hadath, Lebanon ; Department of Nephrology and Organ Transplantation, CHU Rangueil, 31059 Toulouse, France.
authors.forename: Mireille
authors.initials: M
authors.lastname: Mehawej
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, 31059 Toulouse, France ; INSERM U1043, IFR-BMT, CHU Purpan, 31059 Toulouse, France ; Université Paul Sabatier, 31000 Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.affiliation: Université Paul Sabatier, 31000 Toulouse, France ; Service de Médecine Interne-Pole Digestif, CHU Purpan, 31059 Toulouse, France ; Laboratoire EA 2405, INSERM IFR31, 31059 Toulouse, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, 31059 Toulouse, France ; Université Paul Sabatier, 31000 Toulouse, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Del Bello
authors.affiliation: INSERM U1043, IFR-BMT, CHU Purpan, 31059 Toulouse, France ; Université Paul Sabatier, 31000 Toulouse, France ; Laboratory of Virology, CHU Purpan, 31059 Toulouse, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.affiliation: Department of Nephrology and Organ Transplantation, CHU Rangueil, 31059 Toulouse, France ; INSERM U1043, IFR-BMT, CHU Purpan, 31059 Toulouse, France ; Université Paul Sabatier, 31000 Toulouse, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar