NEVŞEHİR İLİNDE KRONİK HEPATİT C HASTALARINDA BOCEPREVİR VE TELAPREVİR KOMBİNASYON TEDAVİSİ SONUÇLARI

Kronik hepatit C infeksiyonu Türkiye’de önemli bir sağlık sorunudur. Türkiye’de en sık görülen hepatitis C virüs (HCV) genotipi 1b’dir. Hepatit C tedavisinde önemli gelişmelerden biri proteaz inhibitörleri boceprevir (BOC) ve telaprevirin (TVR) kullanıma girmesidir. Hepatit C genotip 1 ile infekte hastalarda pegile interferon-alfa ve ribavirin (PegIFN/RBV) ile beraber BOC ve TVR kullanımı kalıcı virolojik cevap (KVC) oranlarını belirgin olarak artırmıştır. Bu çalışmada kompanse karaciğer hastalığı olan HCV genotip 1 ile infekte, daha önce PegIFN/RBV tedavisi almış ama KVC elde edilememiş hastalar- da yeniden tedavide PegIFN/RBV kombinasyonuna eklenen BOC ve TVR etkinliği ve yan etkileri değerlendirmek amaçlan- mıştır. Toplam 22 hastanın 14’ünde (% 63.6) KVC elde edilmiştir. BOC grubunda en sık gözlenen yan etkiler halsizlik, kuru cilt, bulantı, anemi, nötropeni ve TVR grubunda ise anemi, kuru cilt, bulantı ve halsizlik olmuştur. PegIFN/RBV ile beraber BOC ve TVR kullanımı ile KVC yüksek oranda saptanmıştır. Yan etkilerin sıklığına rağmen kombinasyon tedavisinin kesilme oranı düşük olmuştur.

Results of Boceprevir and Telaprevir Combination Therapy in Chronic Hepatitis C Patients in Nevşehir Province

Chronic Hepatitis C infection is an important health problem in Turkey. The most frequently observed hepatitis C virus (HCV) genotype in Turkey is genotype 1b. Protease inhibitor antiviral agents boceprevir (BOC) and telaprevir (TVR) for HCV infection are one of the major advances in its medical treatment. The combination of BOC and TVR with pegylated interferon- alpha and ribavirin (PegIFN/RBV) for the treatment of patients infected with HCV genotype 1 has caused significantly inc- reased rates of sustained virologic response (SVR). In this study, we aimed to evaluate the efficacy and adverse effects of BOC and TVR with PegIFN/RBV for the retreatment of patients infected with HCV genotype 1 who have compensated liver dise- ase and who have previously received PegIFN/RBV therapy but could not achieve SVR. Sustained virologic response was achieved in 14 (63.6 %) of the 22 patients. The most observed adverse effects were anaemia, dry skin, nausea, fatigue at TVR group and fatigue, dry skin, nausea, anaemia and neutropenia at BOC group. Sustained virologic response rates were high with the combination of BOC and TVR with PegIFN/RBV. Although adverse effects were frequently observed, the discontinuation rate of combination therapy was low.

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