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Clinical round-up
  1. Mitesh Desai
  1. Correspondence to Dr Mitesh Desai, Specialty Registrar in GUM, Department of Sexual Health & HIV, St Thomas' Hospital, London SE1 7EH, UK; mdesai.pub{at}gmail.com

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24-week telaprevir combination therapy is just as effective as 48-week treatment in chronic HCV-genotype 1 infection with extended virological response

Since the advent of directly acting antiviral therapies, treatment options for chronic hepatitis C virus (HCV) infection continue to increase. However, tolerability continues to be of significant concern and is directly related to treatment duration. Reducing the length of treatment, and thereby reducing levels of short-term morbidity related to HCV treatment, while maintaining rates of sustained viral response is essential.

As part of a non-inferiority randomised trial, 322 patients received 12 weeks of telaprevir (800 mg, every 8 h), peginterferon α-2a (180 μg /week) and weight-adjusted ribavarin (1000–1200 mg/day) followed by peginterferon and ribavarin.1 All these patients had achieved extended rapid virological response as defined by undetectable RNA at week 4 and 12 of therapy and were subsequently randomised at week 20 to continue peginterferon and ribavarin for a total treatment duration of 24 weeks (n=162) or 48 weeks (n=160). Drop-out was significantly higher in the longer treatment duration group (74% vs 99% retention, p<0.001) with 50% being directly related to adverse events.

The median age, mean baseline HCV-RNA …

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