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Boceprevir plus pegylated interferon/ribavirin to re-treat hepatitis C virus genotype 1 in HIV–HCV co-infected patients: final results of the Spanish BOC HIV–HCV Study
Laguno, M.; Von Wichmann, M. A.; Van den Eynde, E.; Navarro, J.; Cifuentes, Carmen; Murillas, J.; Veloso, S.; Martínez-Rebollar, M.; Guardiola, J.M.; Jou, A.; Gómez-Sirvent, J.L.; Cervantes, M.; Pineda, J.A.; López-Calvo, S.; Carrero, Ana; Montes, M.L.; Deig, E.; Tapiz, A.; Ruiz-Mesa, J.D.; Cruceta, A.; de Lazzari, E.; Mallolas, Josep
Introduction: Boceprevir (BOC) was one of the first oral inhibitors of hepatitis C virus (HCV) NS3 protease to be developed. This study assessed the safety and efficacy of BOC + pegylated interferon-α2a/ribavirin (PEG-IFN/RBV) in the retreatment of HIV–HCV co-infected patients with HCV genotype 1. Methods: This was a phase III prospective trial. HIV–HCV (genotype 1) co-infected patients from 16 hospitals in Spain were included. These patients received 4 weeks of PEG-IFN/RBV (lead-in), followed by response-guided therapy with PEG-IFN/RBV plus BOC (a fixed 44 weeks was indicated in the case of cirrhosis). The primary endpoint was the sustained virological response (SVR) rate at 24 weeks post-treatment. Efficacy and safety were evaluated in all patients who received at least one dose of the study drug. Results: From June 2013 to April 2014, 102 patients were enrolled, 98 of whom received at least one treatment dose. Seventy-three percent were male, 34% were cirrhotic, 23% had IL28b CC, 65% had genotype 1a, and 41% were previous null responders. The overall SVR rate was 67%. Previous null-responders and cirrhotic patients had lower SVR rates (57% and 51%, respectively). Seventy-six patients (78%) completed the therapy scheme; the most common reasons for discontinuation were lack of response at week 12 (12 patients) and adverse events (six patients). Conclusions: Response-guided therapy with BOC in combination with PEG-IFN/RBV led to an overall SVR rate of 67%, but an SVR rate of only 51% in patients with cirrhosis. The therapy was generally well tolerated. Although the current standards of care do not include BOC + PEG-IFN/RBV, the authors believe that this combination can be beneficial in situations where new HCV direct antiviral agent interferon-free therapies are not available yet.
-Teràpia PEG-IFN
-RBV + BOC
-Pacients
-VIH-VHC
-Genotip 1
-Inhibidors orals
-Hepatitis C
-Boceprevir
-Proteasa
-Terapia PEG-IFN
-RBV + BOC
-Pacientes
-VIH-VHC
-Genotipo 1
-Inhibidores orales
-Hepatitis C
-Boceprevir
-Peptidasas
-PEG-IFN therapy
-RBV + BOC
-Patients
-VIH-VHC
-Genotype 1
-Oral inhibitors
-Hepatitis C
-Boceprevir
-Protease
-61
-616.9
© 2016 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).
https://creativecommons.org/licenses/by-nc-nd/4.0/
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