Rapid decrease of wild-type hepatitis C virus on telaprevir treatment

Background: Telaprevir (TVR) is a hepatitis C virus (HCV) NS3.4A protease inhibitor that has exhibited antiviral activity in patients with HCV genotype I infection. The viral dynamics in patients dosed with TVR were compared with those reported for patients treated with interferon (IFN). Methods: The dynamics of wild-type HCV genotype 1 in patients dosed with TVR monotherapy (n=36) and TVIR plus pegylated interferon (PEG-IFN)-alpha 2a (n=8) were quantified using a biphasic viral dynamic model. Results: Patients dosed with either TVR monotherapy or TVR plus PEG-IFN-alpha 2a had median first and second phase decreases of 12 per day and 1.1 per day, respectively. The second phase decrease was approximately 10-fold higher than reported values for IFN-based treatments (P<0.0001). Patients dosed with TVR plus PEG-IFN-alpha 2a had a median remaining viral production after blockage (1-epsilon) of -2.37 log(10). In patients dosed with TVR monotherapy, increased TVR dosage of the same schedule was related to better blockage. Conclusions: These results suggested that TVR-based regimens for chronic HCV infection will lead to an early and more rapid viral decrease that could potentially result in higher sustained viral response rates as well as offer the potential for a reduced duration of treatment.