title: Telaprevir-containing triple therapy in acute HCV coinfection: The CHAT Study.
abstract: BACKGROUND
  No published randomized controlled data on the use of direct-acting antivirals (DAA) in acute hepatitis C (AHC) coinfection exist. However, with the AHC epidemic ongoing among men who have sex with men (MSM) these are urgently needed.
  
  
  METHODS
  The CHAT study is a randomized controlled trial of pegylated interferon + ribavirin (PR) plus telaprevir (TVR) for 12-24 weeks versus PR alone for 24-48 weeks in the response-guided treatment of patients with AHC genotype (GT) 1 infection and HIV-1 coinfection in Germany and Great Britain.
  
  
  RESULTS
  34 patients were included: 15 were randomized to the PR arm (arm 1), 19 to the TVR + PR arm (arm 2). All patients were MSM, median age was 40 years. 55% had IL28B C/C GT. Median baseline HCV RNA was 291,227 IU/ml, median alanine aminotransferase was 105 U/l. 85% received cART, all had baseline HIV RNA <40 copies/ml. Overall sustained virological response (SVR12) rate was 79.4% (27/34). SVR12was seen in 12/15 (80%) in arm 1 and in 15/19 (79.8%) in arm 2. Of the four patients without SVR in arm 2, one experienced viraI breakthrough, two were non-responders; in one case HCV protease inhibitor (PI)-associated mutations were selected under TVR (V36M, R155K).
  
  
  CONCLUSIONS
  Due to moderate response rates and additional toxicities 1st generation HCV PIs should not be used in treating acute HCV. While not being licensed, recent study data and guidelines support the use of dual DAA therapy but optimal treatment duration in acute HCV needs further investigation.
authors.affiliation: Department of Medicine I, Bonn University Hospital, Bonn, Germany.|German Centre for Infection Research (DZIF), Partner Site Cologne-Bonn, Bonn, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Boesecke
authors.affiliation: Chelsea and Westminster Hospital, London, UK.
authors.forename: Gurmit K Jagjit
authors.initials: GKJ
authors.lastname: Singh
authors.affiliation: Praxis Hohenstaufenring, Cologne, Germany.
authors.forename: Stefan H-A
authors.initials: SH
authors.lastname: Scholten
authors.affiliation: Infektiologikum, Frankfurt/Main, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lutz
authors.affiliation: zipb, Berlin, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Baumgarten
authors.affiliation: Department of Medicine I, Bonn University Hospital, Bonn, Germany.|Praxis Hohenstaufenring, Cologne, Germany.
authors.forename: Stephan M
authors.initials: SM
authors.lastname: Schneeweiss
authors.affiliation: Gemeinschaftspraxis Schwabstrasse, Stuttgart, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Trein
authors.affiliation: Ärztezentrum Nollendorfplatz, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Rausch
authors.affiliation: zipb, Berlin, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ingiliz
authors.affiliation: Department of Medicine I, Bonn University Hospital, Bonn, Germany.|German Centre for Infection Research (DZIF), Partner Site Cologne-Bonn, Bonn, Germany.
authors.forename: Jürgen K
authors.initials: JK
authors.lastname: Rockstroh
authors.affiliation: Chelsea and Westminster Hospital, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
mesh_terms: D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000821:virology*; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; C486464:telaprevir