Response Guided Treatment with Telaprevir or Boceprevir in End Stage Renal Disease Patients with Hepatitis C Genotype 1

Abstract

Aim: To evaluate and characterize the feasibility, tolerability and efficacy of triple combination therapy with either telaprevir (TPR) or boceprevir (BPR).Methods: We treated 16 genotype 1 HCV patients with ESRD, awaiting renal transplantation at two centers. All patients received pegylated-interferon (P), ribavirin (R), and either boceprevir or telaprevir. All patients with BPR received a 4-week lead-in whereas those with TPR received no lead-in. Data was collected throughout the patients’ treatment course including viral load, dose modification and complications of therapy.Results: Baseline characteristics of the cohort included mean age of 56 years, 75% male, 56% African-American, 63% genotype 1a HCV, 38% with cirrhosis and 69% treatment naïve. eRVR was achieved in 38% (56% in TPR and 14% BPR) with SVR achieved in 44% (33% in TPR and 57% BPR). Over 70% of patients required epoetin for anemia wheareas 22% in TPR required blood transfusions. No patients in either TPR/BPR treatment cohorts discontinued therapy due to side effects.Conclusion: We evaluated and analyzed the efficacy of telaprevir and boceprevir based regimens in the treatment of hepatitis C in patients with end stage renal disease. Triple therapy, irrespective of regimen, can attain successful viral eradication with minimal adverse effects.