Title:Impact of Telaprevir in HCV Patients with Cirrhosis and RVR: Real-Life Data from Boceprevir or Telaprevir based “Triple Therapy” Experience in Southern Italy
Volume: 11
Issue: 4
Author(s): Filomena Morisco, Mario Masarone, Valerio Rosato, Silvia Camera, Rocco Granata, Maria T. Tartaglione, Carmine Coppola, Nicola Coppola, Angelo Salomone-Megna, Ivan Gentile, Antonio De Luna, Alessandro Federico, Davide Precone, Ernesto Claar, Ludovico Abenavoli and Marcello Persico
Affiliation:
Keywords:
Cirrhosis, first generation direct antiviral agents (DAA), HCV viral hepatitis, rapid virological response (RVR)
Abstract: Background and Rationale of Study: The real-life data of triple therapy-based treatment in
patients with chronic hepatitis C were investigated in this survey of 12 clinical centers of southern Italy.
This retrospective study analyzed data from 176 consecutive patients.
Methods: 125 (70%) patients were treated with telaprevir, and 51(30%) with boceprevir. There were no
differences in demographic characteristics between the groups. The degree of Liver Fibrosis (LF) was
evaluated according to Liver Biopsy (LB) and/or Transient Elastography (TE). 53/176 patients (30%)
had liver cirrhosis. Sixteen patients (9%) were treatment naïve, and the remaining were not: 92 were
non-responders (52, 84%), 63 relapsed (35,79%), and 5 discontinued treatment (2, 8%).
Results: Overall, the rapid Virological Response (RVR) rate was 67.6%. Of the 103 patients who had
follow-up for at least 12 weeks after the end of treatment, 61 (59, 2%) achieved a Sustained Virological
Response (SVR). According to multivariate analysis for SVR, RVR was the only independent
predictive factor of SVR, irrespective of the degree of LF and the type of response to previous
treatments. In telaprevir-treated patients, the rate of RVR was similar in patients with F0-F2, F3 and F4
fibrosis (85%, 84%, 78%, respectively), and the SVR rates among RVR patients was similar
irrespective of LF.
Conclusions: Data from this real-life study confirm the efficacy reported in clinical trials, although
cirrhosis appears to play a smaller role in influencing treatment efficacy. Moreover, RVR is the only
independent predictive factor of response regardless of cirrhosis. Based on RVR and for patients with
cirrhosis, a shorter therapy might be considered, at least with telaprevir-based therapy.
