Telaprevir: options of application in separate patient groups

The aim of review. To discuss potential of telaprevir application in patients with the 1-st genotype of chronic hepatitis C (CHC) representing certain difficulties in treatment, in patients having antiviral therapy experience, patients with liver cirrhosis, including, those, enrolled to liver transp...

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Main Authors: M. V. Mayevskaya, I. N. Tikhonov, V. T. Ivashkin
Format: Article
Language:Russian
Published: Gastro LLC 2013-10-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/1231
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author M. V. Mayevskaya
I. N. Tikhonov
V. T. Ivashkin
author_facet M. V. Mayevskaya
I. N. Tikhonov
V. T. Ivashkin
author_sort M. V. Mayevskaya
collection DOAJ
description The aim of review. To discuss potential of telaprevir application in patients with the 1-st genotype of chronic hepatitis C (CHC) representing certain difficulties in treatment, in patients having antiviral therapy experience, patients with liver cirrhosis, including, those, enrolled to liver transplantation waiting list, and after liver transplantation, in patients with human immunodeficiency virus coinfection, as well as nephrologic patients receiving renal substitution therapy.Key points. Adding of NS3/4A protease inhibitor telaprevir to treatment mode for patients infected with 1-st genotype of hepatitis C virus for 12 wks allowed to increase treatment response rate considerably. The potential of decreasing of antiviral therapy (AVT) duration to 24 wks is proved, based on dynamics of viral load at AVT, at week 4 and 12 of treatment in patients who receiving no AVTs earlier, and in groups, representing as a rule, difficulty for treatment (patients with CHC relapse or absence the response/incomplete response to previous AVT). Patients with liver cirrhosis who represent quite heterogenic group require special approach. AVT in patients with compensated cirrhosis, those, enrolled to liver transplantation waiting list (if MELD index ≤18 and Child-Pugh score ≤8 points), with good efficacy and adequate treatment safety profile is now available. Known risk factors of death or severe adverse events are level of platelets under 100 Gi/L, serum albumin level less than 3,5 g/dl, and HVPG ≥10 mm Hg. Studying of telaprevir application options for treatment of patients with CHC relapse in post-transplantation period, patients with chronic renal disease, including those, receiving renal substitution therapy is still in progress. The primary data received in studies, devoted to these issues, enable to expect expansion of indications and options of three-componential AVT application.Conclusion. According to data of original studies, inclusion of telaprevir in treatment mode of patients with 1-st genotype of chronic hepatitis C increases treatment response rate in group of patients with unsuccessful AVT experience, severe fibrosis or liver cirrhosis, and unseals new options of treatment of patients from the liver transplantation waiting list, after transplantation and in group of chronic renal disease.
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spelling doaj-art-fc23f94321634da495bd3e7fd973f6142025-02-10T16:14:33ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732013-10-012354656818Telaprevir: options of application in separate patient groupsM. V. Mayevskaya0I. N. Tikhonov1V. T. Ivashkin2State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationThe aim of review. To discuss potential of telaprevir application in patients with the 1-st genotype of chronic hepatitis C (CHC) representing certain difficulties in treatment, in patients having antiviral therapy experience, patients with liver cirrhosis, including, those, enrolled to liver transplantation waiting list, and after liver transplantation, in patients with human immunodeficiency virus coinfection, as well as nephrologic patients receiving renal substitution therapy.Key points. Adding of NS3/4A protease inhibitor telaprevir to treatment mode for patients infected with 1-st genotype of hepatitis C virus for 12 wks allowed to increase treatment response rate considerably. The potential of decreasing of antiviral therapy (AVT) duration to 24 wks is proved, based on dynamics of viral load at AVT, at week 4 and 12 of treatment in patients who receiving no AVTs earlier, and in groups, representing as a rule, difficulty for treatment (patients with CHC relapse or absence the response/incomplete response to previous AVT). Patients with liver cirrhosis who represent quite heterogenic group require special approach. AVT in patients with compensated cirrhosis, those, enrolled to liver transplantation waiting list (if MELD index ≤18 and Child-Pugh score ≤8 points), with good efficacy and adequate treatment safety profile is now available. Known risk factors of death or severe adverse events are level of platelets under 100 Gi/L, serum albumin level less than 3,5 g/dl, and HVPG ≥10 mm Hg. Studying of telaprevir application options for treatment of patients with CHC relapse in post-transplantation period, patients with chronic renal disease, including those, receiving renal substitution therapy is still in progress. The primary data received in studies, devoted to these issues, enable to expect expansion of indications and options of three-componential AVT application.Conclusion. According to data of original studies, inclusion of telaprevir in treatment mode of patients with 1-st genotype of chronic hepatitis C increases treatment response rate in group of patients with unsuccessful AVT experience, severe fibrosis or liver cirrhosis, and unseals new options of treatment of patients from the liver transplantation waiting list, after transplantation and in group of chronic renal disease.https://www.gastro-j.ru/jour/article/view/1231protease inhibitorstelaprevirchronic hepatitis c1-st genotyperelapseprolonged rapid virologic responseliver cirrhosistransplantationchronic disease of kidneyshemodialysis
spellingShingle M. V. Mayevskaya
I. N. Tikhonov
V. T. Ivashkin
Telaprevir: options of application in separate patient groups
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
protease inhibitors
telaprevir
chronic hepatitis c
1-st genotype
relapse
prolonged rapid virologic response
liver cirrhosis
transplantation
chronic disease of kidneys
hemodialysis
title Telaprevir: options of application in separate patient groups
title_full Telaprevir: options of application in separate patient groups
title_fullStr Telaprevir: options of application in separate patient groups
title_full_unstemmed Telaprevir: options of application in separate patient groups
title_short Telaprevir: options of application in separate patient groups
title_sort telaprevir options of application in separate patient groups
topic protease inhibitors
telaprevir
chronic hepatitis c
1-st genotype
relapse
prolonged rapid virologic response
liver cirrhosis
transplantation
chronic disease of kidneys
hemodialysis
url https://www.gastro-j.ru/jour/article/view/1231
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AT intikhonov telapreviroptionsofapplicationinseparatepatientgroups
AT vtivashkin telapreviroptionsofapplicationinseparatepatientgroups