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Protease Inhibitor Use for Chronic Hepatitis C infection in Special Populations: A Review of the Clinical Evidence and Guidelines

Published on: March 8, 2012
Project Number: RC0327-004
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the evidence for the clinical benefit and harm of using boceprevir or telaprevir in patients with chronic hepatitis C infection who are co-infected with HIV?
  2. What are recommendations from evidence-based guidelines on treatment of HIV co-infected patients with chronic hepatitis C infection with boceprevir or telaprevir?
  3. What is the clinical evidence on sustained virological response rates with the protease inhibitors in patients who are classified as null responders on prior PR therapy?
  4. What is the clinical evidence on sustained virological response rates with the protease inhibitors for patients with CHC infection and Metavir scores of F0 or F1?

Key Message

At present, there is insufficient evidence to determine the clinical benefit and harm of adding boceprevir or telaprevir to PR in patients with CHC co-infected with HIV. CHC patients who are null responders to previous PR therapy may benefit from telaprevir-PR, although the response rate is expected to be lower than in the general CHC population. There are no RCT data on this population for boceprevir-PR. Similar to the overall trial populations in the included studies, patients with CHC infection and metavir scores of F0 or F1 (telaprevir) or F0-F2 (boceprevir) achieved higher SVR rates with protease inhibitors added to PR over PR alone. Response rates with PI-PR were generally higher at earlier stages of fibrosis compared with later stages in treatment-naïve patients, but not in treatment-experienced patients.

Tags

hepatitis, hepatitis c, protease inhibitors, hepatitis c virus, hepatitis c, chronic, chronic hepatitis c