Response to peginterferon plus ribavirin and subsequent retreatment with telaprevir-based triple therapy in a patient with chronic lymphocytic leukaemia and chronic HCV genotype 1b infection

Background: Case-controlled studies have clearly demonstrated a link between chronic hepatitis C infection (CHC) and B cell non-Hodgkin lymphoma (NHL). To our knowledge, this is the first case report of outcome in a patient with CLL and chronic HCV infection treated with PEG-IFN/RBV and subsequent retreated with triple therapy. Findings: We report the case of a 54-year old, caucasian woman with a history of elevated liver enzymes diagnosed with chronic lymphocytic leukaemia (CLL) detected during investigation for hepatitis C (HCV) infection. The patient showed a haematological response following initially successful anti-HCV therapy with peginterferon plus ribavirin (PEG-IFN/RBV), with normalization of leukocyte and lymphocyte counts. She subsequently showed a late virological relapse at week 24, and was successfully retreated with telaprevir-based triple therapy. Despite an increase in leucocyte and lymphocyte count compared to baseline following triple therapy, to date there is no evidence of progression of CLL and the patient remains asymptomatic. Conclusion: Patients with CLL may experience haematological response following successful anti-HCV therapy using IFN-based regimens. Re-treatment with triple therapy including telaprevir following late virological relapse was successful, was not associated with any unexpected safety issues, and did not adversely affect CLL status.