Telaprevir or boceprevir based therapy for chronic hepatitis C infection: development of resistance-associated variants in treatment failure.

Macartney, Malcolm, Irish, Dianne, Bridge, Simon, Garcia-Diaz, Ana, Booth, Clare, McCormick, Adele, Labbett, Wendy, Smith, Colette, Velazquez, Carmen, Tanwar, Sudeep, Trembling, Paul, Jacobs, Michael, Dusheiko, Geoff, Rosenberg, William and Haque, Tanzina (2014) Telaprevir or boceprevir based therapy for chronic hepatitis C infection: development of resistance-associated variants in treatment failure. Antiviral Research, 105. pp. 112-117. ISSN 1872-9096

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Abstract

The use of triple-therapy, pegylated-interferon, ribavirin and either of the first generation hepatitis C virus (HCV) protease inhibitors telaprevir or boceprevir, is the new standard of care for treating genotype 1 chronic HCV. Clinical trials have shown response rates of around 70-80%, but there is limited data from the use of this combination outside this setting. Through an expanded access programme, we treated 59 patients, treatment naïve and experienced, with triple therapy. Baseline factors predicting treatment response or failure during triple therapy phase were identified in 58 patients. Thirty seven (63.8%) of 58 patients had undetectable HCV RNA 12weeks after the end of treatment. Genotype 1a (p=0.053), null-response to previous treatment (p=0.034), the rate of viral load decline after 12weeks of previous interferon-based treatment (p=0.033) were all associated with triple-therapy failure. The most common cause of on-treatment failure for telaprevir-based regimens was the development of resistance-associated variants (RAVs) at amino acids 36 and/or 155 of HCV protease (p=0.027) whereas in boceprevir-based regimens mutations at amino acid 54 were significant (p=0.015). SVR12 rates approaching 64% were achieved using triple therapy outside the clinical trial setting, in a patient cohort that included cirrhotics.

Item Type:	Article
Additional Information:	PMID: 24594347
Subjects:	A300 Clinical Medicine
Department:	Faculties > Health and Life Sciences > Applied Sciences
Depositing User:	Dr Simon Bridge
Date Deposited:	10 Oct 2016 09:02
Last Modified:	12 Oct 2019 18:29
URI:	http://nrl.northumbria.ac.uk/id/eprint/27939

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