Rapid virological response of telaprevir and boceprevir in a Brazilian cohort of HCV genotype 1 patients: A multicenter longitudinal study

Borba, HHL; Wiens, A; Steimbach, LM; Tonin, FS; Pedroso, MLA; Ivantes, CAP; Fernandez-Llimos, F; Pontarolo, R

Rapid virological response of telaprevir and boceprevir in a Brazilian cohort of HCV genotype 1 patients: A multicenter longitudinal study

Borba, HHL Wiens, A Steimbach, LM Tonin, FS Pedroso, MLA Ivantes, CAP Fernandez-Llimos, F

Pontarolo, R

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Publication Type:: Journal Article
Citation:: Therapeutics and Clinical Risk Management, 2017, 13 pp. 59 - 64
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Borba, HHL	en_US
dc.contributor.author	Wiens, A	en_US
dc.contributor.author	Steimbach, LM	en_US
dc.contributor.author	Tonin, FS	en_US
dc.contributor.author	Pedroso, MLA	en_US
dc.contributor.author	Ivantes, CAP	en_US
dc.contributor.author	Fernandez-Llimos, F https://orcid.org/0000-0002-8529-9595	en_US
dc.contributor.author	Pontarolo, R	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	Therapeutics and Clinical Risk Management, 2017, 13 pp. 59 - 64	en_US
dc.identifier.issn	1176-6336	en_US
dc.identifier.uri	http://hdl.handle.net/10453/125322
dc.description.abstract	© 2017 Borba et al. Background: Chronic hepatitis C is a major public health issue, but there is a gap in the literature regarding the effectiveness and safety of direct-acting antiviral agents in the Brazilian population. The main aim of this study was to describe the effectiveness of boceprevir and telaprevir in patients treated at public health care institutions in Brazil. Materials and methods: A prospective longitudinal and multicenter study was conducted in five centers in the State of Paraná between September 2014 and June 2016. Data regarding effectiveness and safety were collected from medical records of patients treated with boceprevir or telaprevir. The effectiveness outcome comprised the rapid virological response (RVR). Multivariate analysis was performed to verify the influence of independent variables (ie, age, gender, baseline viral load) on RVR achievement. Results: Data were collected from 117 patients with chronic hepatitis C virus (HCV) genotype 1 infection. Fifteen patients received treatment with boceprevir and 102 received telaprevir. The mean age was 51.6 years, 64.1% were male, 44.4% were infected with HCV subtype 1a, 62.4% had a high baseline viral load (≥800,000 IU/mL) and 33% were cirrhotic. Furthermore, 79.5% of patients achieved RVR (26.7% in the boceprevir group and 87.3% in the telaprevir group). Multivariate analysis demonstrated that the type of protease inhibitor (boceprevir or telaprevir) and the baseline viral load had an influence on the RVR rate (odds ratio [OR] =0.011; 95% confidence interval [CI]: 0.001–0.119; P<0.001/OR =13.004; 95% CI: 1.522–111.115; P=0.019, respectively). Conclusion: In this longitudinal multicenter cohort study conducted from the Brazilian perspective, differences were found in the RVR rates, favoring telaprevir over boceprevir for genotype 1 HCV-infected patients. In addition, the baseline viral load was associated with RVR achievement in both evaluated groups. As RVR is also reported in the literature as a predictor of the sustained virological response (SVR), further analyses of RVR as predictor of SVR outcomes should be further evaluated in Brazil.	en_US
dc.relation.ispartof	Therapeutics and Clinical Risk Management	en_US
dc.relation.isbasedon	10.2147/TCRM.S124663	en_US
dc.subject.classification	Oncology & Carcinogenesis	en_US
dc.title	Rapid virological response of telaprevir and boceprevir in a Brazilian cohort of HCV genotype 1 patients: A multicenter longitudinal study	en_US
dc.type	Journal Article
utslib.citation.volume	13	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access
pubs.publication-status	Published	en_US
pubs.volume	13	en_US

Abstract:

© 2017 Borba et al. Background: Chronic hepatitis C is a major public health issue, but there is a gap in the literature regarding the effectiveness and safety of direct-acting antiviral agents in the Brazilian population. The main aim of this study was to describe the effectiveness of boceprevir and telaprevir in patients treated at public health care institutions in Brazil. Materials and methods: A prospective longitudinal and multicenter study was conducted in five centers in the State of Paraná between September 2014 and June 2016. Data regarding effectiveness and safety were collected from medical records of patients treated with boceprevir or telaprevir. The effectiveness outcome comprised the rapid virological response (RVR). Multivariate analysis was performed to verify the influence of independent variables (ie, age, gender, baseline viral load) on RVR achievement. Results: Data were collected from 117 patients with chronic hepatitis C virus (HCV) genotype 1 infection. Fifteen patients received treatment with boceprevir and 102 received telaprevir. The mean age was 51.6 years, 64.1% were male, 44.4% were infected with HCV subtype 1a, 62.4% had a high baseline viral load (≥800,000 IU/mL) and 33% were cirrhotic. Furthermore, 79.5% of patients achieved RVR (26.7% in the boceprevir group and 87.3% in the telaprevir group). Multivariate analysis demonstrated that the type of protease inhibitor (boceprevir or telaprevir) and the baseline viral load had an influence on the RVR rate (odds ratio [OR] =0.011; 95% confidence interval [CI]: 0.001–0.119; P<0.001/OR =13.004; 95% CI: 1.522–111.115; P=0.019, respectively). Conclusion: In this longitudinal multicenter cohort study conducted from the Brazilian perspective, differences were found in the RVR rates, favoring telaprevir over boceprevir for genotype 1 HCV-infected patients. In addition, the baseline viral load was associated with RVR achievement in both evaluated groups. As RVR is also reported in the literature as a predictor of the sustained virological response (SVR), further analyses of RVR as predictor of SVR outcomes should be further evaluated in Brazil.

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http://hdl.handle.net/10453/125322