Sustained virological response in a patient with chronic hepatitis C treated by monotherapy with the NS3-4A protease inhibitor telaprevir

[Upbeat]

Here, we describe for the first time a case of sustained virological response (SVR) achieved in a patient with chronic hepatitis C (CH-C) by monotherapy with a NS3-4A protease inhibitor, telaprevir, without interferon therapy. A 59-year-old treatment-naïve Japanese man was enrolled in a phase II trial of telaprevir by repeat oral administration at a dose of 750mg every 8h for 24 weeks. At the start of treatment, he exhibited a low-level viremia with genotype 1b of the hepatitis C virus (HCV). After the first week of treatment with telaprevir, serum HCV RNA was undetectable, and negativity remained until the end of treatment. Moreover, he was evaluated as having a SVR after the post-treatment 24-week follow-up program. Two characteristics may explain the strong antiviral activity of telaprevir in the present case. First, although pre-treatment PCR-direct sequencing and cloning for the N-terminal in the NS3 region showed a protease inhibitor-resistant variant (T54A) in 1 of 32 independent clones, the T54A substitution has only a low-level resistance to protease inhibitors and his viral load was low. Second, when compared to a consequence sequence of 35 treatment-naïve patients with HCV genotype 1b, R130K and Q195K substitutions were unique to the present case. Although it is presently unknown whether the R130K and Q195K substitutions are related to SVR, this case suggests that long-term telaprevir monotherapy may be effective in CH-C patients with genotype 1 and a low viral load

PMID: 19857995 [PubMed - as supplied by publisher

[annieCinMD]

'This is terrific news.  I think we will all rejoice when a cure is found without Interferon in the mix. '   Amen to that!  I don't think I'll treat again with ifn unless I have to. At 1/1 at last biopsy, I don't have to.

[gypsyjoey]

I was on a Telapravir trial so news like this excites me almost more than going skydiving on the weekend.
Joey

[robo229]

This is terrific news.  I think we will all rejoice when a cure is found without Interferon in the mix.  Can you provide a more complete reference?

So long as interferon/ Riba are referred to as "SOC" , Drs. and drug companies will be reluctant to think outside the box on treatment.

As a physician myself, nothing makes risk managers worry and plaintiff's attorneys salivate more than when a Doc deviates from "Standard of Care".  For centuries bloodletting was "SOC" for many illnesses...I'm looking forward to the day when Ifn/riba are historical footnotes.

Thanks for sharing.
Happy Thanksgiving,

Robo

[epiphiny]

Wow, that's very encouraging news, isn't it!  Thanks for posting :)