Early virological assessment during telaprevir- or boceprevir-based triple therapy in hepatitis C cirrhotic patients who failed a previous interferon based regimen - The ANRS CO20-CUPIC study.
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Date publication
janvier 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BRONOWICKI Jean-Pierre
Tous les auteurs :
Bailly F, Virlogeux V, Dufour C, Pradat P, Hezode C, Larrey D, Alric L, Samuel D, Bourliere M, Metivier S, Zarski JP, Fontaine H, Loustaud-Ratti V, Serfaty L, Bronowicki JP, Carrat F, Zoulim F
Lien Pubmed
Résumé
BACKGROUND AND OBJECTIVE: To assess within the ANRS CO20-CUPIC cohort whether the viral load (VL) at week2/week6 for telaprevir/boceprevir-based triple therapy, respectively, was predictive of sustained virological response (SVR) in patients with hepatitis C virus (HCV) infection and to study the relevance of this measurement to early diagnose drug resistance. METHODS: Observational study of HCV genotype 1 patients with compensated cirrhosis (Child-Pugh A), non-responders to a prior course of interferon (IFN)-based therapy and who started triple therapy. Patients received either 12weeks of telaprevir in combination with PEG-IFN/ribavirin (RBV), then 36weeks of PEG-IFN/RBV, or 4weeks of PEG-IFN/RBV, then 44weeks of PEG-IFN/RBV and boceprevir. RESULTS: A total of 262 patients were analyzed. For telaprevir-treated patients, 28% had undetectable VL at W2 of whom 81% achieved SVR12 whereas 67% had undetectable VL at W4 of whom 67% achieved SVR12. For boceprevir-treated patients 20% had undetectable VL at W6 and 86% of them achieved SVR12 whereas 36% had undetectable VL at W8 among whom 73% achieved SVR12. Five telaprevir-treated patients had a VL increase between W2 and W4 after a decrease between D0 and W2. Four of them did not achieve SVR12. Similarly, six boceprevir-treated patients had a VL increase between W6 and W8 after a decrease between D0 and W6. Five did not reach SVR12. CONCLUSIONS: The assessment of HCV RNA level after two weeks of triple therapy in cirrhotic non-responder patients is a good predictor of SVR. This assessment was useful to do an early diagnosis of viral breakthrough.
Référence
Clin Res Hepatol Gastroenterol. 2015 Jan 27. pii: S2210-7401(15)00002-9