[Combined telaprevir plus ribavirin and pegylated interferon therapy for patients with chronic hepatitis C].

Antiviral efficacy of combined Peg-IFN-α2b plus ribavirin therapy was improved by the addition of telaprevir, a first-generation NS3/4A protease inhibitor, in patients with chronic hepatitis due to HCV infection. A multicenter prospective study revealed that the triple therapy with telaprevir administered according to an algorithm based on the drug adherence, IL28B polymorphism and viral response yielded a high SVR rate through attenuation of viral relapse by prolonged ribavirin/Peg-IFN-α2b administration. Such triple therapy, however, may provoke various adverse effects potentially necessitating treatment discontinuation; dermatitis, hemolytic anemia, hyperuricemia, renal impairment and retinopathy. Thus, the role of telaprevir as a direct-acting antiviral agent used in combination with Peg-IFN and ribavirin for patients with genotype 1b HCV infection was replaced by simeprevir, a second-generation NS3/4A protease inhibitor. However, telaprevir still plays an important role in the treatment for patients with genotypes 2a and 2b HCV infection as well as those showing viral breakthrough after antiviral therapies using second-generation NS3/4A protease inhibitors.