Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results.
Management of recurrent Hepatitis C virus (HCV) infection following liver transplantation remains a major challenge. In non-transplanted HCV genotype 1 patients, the introduction of protease inhibitor-based regimens has significantly increased the rate of sustained virological response. In this foll...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3827217?pdf=render |
| _version_ | 1831685036107104256 |
|---|---|
| author | Christoph R Werner Daniel P Egetemeyr Ulrich M Lauer Silvio Nadalin Alfred Königsrainer Nisar P Malek Christoph P Berg |
| author_facet | Christoph R Werner Daniel P Egetemeyr Ulrich M Lauer Silvio Nadalin Alfred Königsrainer Nisar P Malek Christoph P Berg |
| author_sort | Christoph R Werner |
| collection | DOAJ |
| description | Management of recurrent Hepatitis C virus (HCV) infection following liver transplantation remains a major challenge. In non-transplanted HCV genotype 1 patients, the introduction of protease inhibitor-based regimens has significantly increased the rate of sustained virological response. In this follow-up study, on the first published cohort of post-liver transplant patients treated with telaprevir-based triple therapy, we investigated both efficacy and safety data in follow-up to 24 weeks (SVR 24) after end of treatment (EOT). SVR 24 efficacy and safety data from 9 liver transplant HCV patients being treated with telaprevir, pegylated interferon, and ribavirin, showed 5 of the transplanted patients accomplished the full duration of the 48 week triple therapy. Notable were the 4 patients found to be HCV RNA-negative at week 4, and 8 patients at week 12. Upon EOT, at week 48, 6 patients were HCV RNA-negative. Importantly, at follow-up (24 weeks after EOT), a favorable sustained virological response rate was observed in 5 of these patients with HCV RNA remaining negative, including in one patient who discontinued treatment prematurely. Due to side effects, 2 patients discontinued, 2 suffered from virological breakthrough after the telaprevir treatment phase, and 1 patient had a relapse after EOT. Two thirds of patients exhibited hematological side effects requiring ribavirin dose reductions, administration of erythropoetin, or even blood transfusions. This retrospective analysis provides evidence that--with respect to SVR 24--liver transplant patients suffering from HCV genotype 1 recurrence may benefit from a telaprevir-based triple therapy as this new regimen showed acceptable antiviral efficacy in this small cohort of mostly pre-treated patients. Management of drug-drug interactions is challenging, but feasible. In part severe side effects are frequent during treatment and require therapeutic interventions. |
| first_indexed | 2024-12-20T08:12:06Z |
| format | Article |
| id | doaj.art-81bf4cdd17c044a083b1b6d20611ef25 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T08:12:06Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-81bf4cdd17c044a083b1b6d20611ef252022-12-21T19:47:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e8052810.1371/journal.pone.0080528Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results.Christoph R WernerDaniel P EgetemeyrUlrich M LauerSilvio NadalinAlfred KönigsrainerNisar P MalekChristoph P BergManagement of recurrent Hepatitis C virus (HCV) infection following liver transplantation remains a major challenge. In non-transplanted HCV genotype 1 patients, the introduction of protease inhibitor-based regimens has significantly increased the rate of sustained virological response. In this follow-up study, on the first published cohort of post-liver transplant patients treated with telaprevir-based triple therapy, we investigated both efficacy and safety data in follow-up to 24 weeks (SVR 24) after end of treatment (EOT). SVR 24 efficacy and safety data from 9 liver transplant HCV patients being treated with telaprevir, pegylated interferon, and ribavirin, showed 5 of the transplanted patients accomplished the full duration of the 48 week triple therapy. Notable were the 4 patients found to be HCV RNA-negative at week 4, and 8 patients at week 12. Upon EOT, at week 48, 6 patients were HCV RNA-negative. Importantly, at follow-up (24 weeks after EOT), a favorable sustained virological response rate was observed in 5 of these patients with HCV RNA remaining negative, including in one patient who discontinued treatment prematurely. Due to side effects, 2 patients discontinued, 2 suffered from virological breakthrough after the telaprevir treatment phase, and 1 patient had a relapse after EOT. Two thirds of patients exhibited hematological side effects requiring ribavirin dose reductions, administration of erythropoetin, or even blood transfusions. This retrospective analysis provides evidence that--with respect to SVR 24--liver transplant patients suffering from HCV genotype 1 recurrence may benefit from a telaprevir-based triple therapy as this new regimen showed acceptable antiviral efficacy in this small cohort of mostly pre-treated patients. Management of drug-drug interactions is challenging, but feasible. In part severe side effects are frequent during treatment and require therapeutic interventions.http://europepmc.org/articles/PMC3827217?pdf=render |
| spellingShingle | Christoph R Werner Daniel P Egetemeyr Ulrich M Lauer Silvio Nadalin Alfred Königsrainer Nisar P Malek Christoph P Berg Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. PLoS ONE |
| title | Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. |
| title_full | Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. |
| title_fullStr | Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. |
| title_full_unstemmed | Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. |
| title_short | Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results. |
| title_sort | feasibility of telaprevir based triple therapy in liver transplant patients with hepatitis c virus svr 24 results |
| url | http://europepmc.org/articles/PMC3827217?pdf=render |
| work_keys_str_mv | AT christophrwerner feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT danielpegetemeyr feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT ulrichmlauer feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT silvionadalin feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT alfredkonigsrainer feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT nisarpmalek feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results AT christophpberg feasibilityoftelaprevirbasedtripletherapyinlivertransplantpatientswithhepatitiscvirussvr24results |