Iliescu Laura, Toma Letiția, Minzala Georgiana
Fundeni Clinical Institute
Abstract
Background. As chronic HVC infection is one of the most common infections worldwide, with significant impact on morbidity and mortality, it is important to study the possible curative treatments and their prognostic factors. Triple therapy with interferon, ribavirin and a protease inhibitor (boceprevir) is an important step in the management of HVC positive patients who do not respond to double therapy. We present response rates and predictive factors of the triple therapy with Peginterferon + Ribavirin + Boceprevir. Methods. We included 27 patients with treatment failure to the initial therapy. We initially determined their IL28B genotype, viremia, degree of fibrosis and the response type to the initial therapy. On follow-up we tested their viremia at 4, 8, 12, 24, 48 and 72 weeks after the start of triple therapy. Results. Sustained Virologic Response (SVR) was achieved in four patients from the seven patients who have reached the 6 month period from the end of the treatment. The remainder of three patients had relapse after receiving the triple therapy. Seventeen patients (77.27%) had undetectable plasma levels of HCV RNA at week 48. An undetectable HCV RNA level was not achieved by treatment week 24 in three patients (13,63%) and all their therapy was discontinued. Also, all treatment was discontinued in two patients before week 24 due to severe adverse events. Conclusion. IL28B genotype, degree of fibrosis and type of response to previous therapy can be associated in order to predict the virologic response to triple therapy in HCV infection.