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High incidence of serious adverse events in HIV-infected patients treated with a telaprevir-based hepatitis C virus treatment regimen

Cachay, Edward R.a,b; Wyles, David L.a,b; Torriani, Francesca J.a,b; Ballard, Craigc; Colwell, Bradfordc; Lin, Jennifer C.b; Hill, Lucasc; Mathews, William C.a

doi: 10.1097/01.aids.0000432466.15885.14
Clinical Science: Concise Communication

Objectives: To report the rates of grade IV adverse events and hepatitis C virus (HCV) treatment discontinuation associated with the use of telaprevir, pegylated interferon, and ribavirin.

Design: Retrospective cohort analysis.

Methods: The study included patients coinfected with HIV and HCV who underwent HCV treatment in a clinic-based setting with telaprevir, pegylated interferon, and ribavirin. The United States of America National Institutes of Health Division of AIDS grading system was used to rate severity of adverse events.

Results: Of the 24 consecutive patients treated for HCV using telaprevir/pegylated interferon/ribavirin, 50% (12/24) developed serious adverse events and 29% (7/24) discontinued HCV treatment due to adverse events, despite an intensive multidisciplinary monitoring approach.

Conclusion: In this HIV clinic-based experience, a high rate of grade IV adverse events and treatment discontinuations were observed associated with HCV telaprevir-based treatment. Careful consideration of the risks and benefits of telaprevir-based therapy should be undertaken, given prospects for interferon-sparing therapy in the near future.

aDepartment of Medicine, Owen Clinic

bDivision of Infectious Diseases, Department of Medicine

cSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California at San Diego, San Diego, California, USA.

Correspondence to Edward Cachay, MD, MAS, University of California at San Diego, 200 W. Arbor Drive, San Diego, CA 92103–8681, USA. Tel: +1 619 543 3939; fax: +1 619 543 7841; e-mail: ecachay@ucsd.edu

Received 30 May, 2013

Revised 17 June, 2013

Accepted 24 June, 2013

© 2013 Lippincott Williams & Wilkins, Inc.