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Treatment for Hepatitis C Virus Infection in Adults: Comparative Effectiveness

Slide: 27 of 34

Conclusions (1 of 2)

In treatment-naïve patients with chronic hepatitis C virus (HCV) infection, both dual therapy and triple therapy produced sustained virologic responses (SVRs).

In patients with HCV genotype 1 infection, triple therapy with pegylated interferon, ribavirin, and either boceprevir or telaprevir resulted in substantially higher SVR rates when compared with dual therapy with pegylated interferon plus ribavirin.

  • Triple therapy with boceprevir for 48 weeks in patients with HCV genotype 1 infection was associated with a higher likelihood of achieving an SVR when compared with dual therapy for 48 weeks, with an absolute increase in the SVR rate of 31 percent.
  • Triple therapy with telaprevir for 24 weeks in patients with HCV genotype 1 infection was associated with a higher likelihood of achieving an SVR when compared with dual therapy for 48 weeks, with an absolute increase in the SVR rate of 22 percent. Response-guided triple therapy with telaprevir also resulted in a higher likelihood of achieving an SVR when compared with dual therapy for 48 weeks; the absolute increase in the SVR rate was 25–31 percent. However, evidence for superior efficacy of response-guided triple therapy came from a single trial.

The likelihood of achieving an SVR was similar with dual therapy of pegylated interferon alfa-2a and ribavirin and dual therapy with pegylated interferon alfa-2b and ribavirin; however, there appeared to be a slightly higher likelihood of achieving an SVR with dual therapy of pegylated interferon alfa-2a. The absolute difference in the SVR rates was small (8%).

For patients with HCV genotype 2 or 3 infection, standard doses of pegylated interferon (1.5 mcg/kg or 100–150 mcg) in dual therapy regimens were more effective than lower doses (0.75 mcg/kg or 50 mcg). Additionally, the standard duration of treatment with pegylated interferon plus ribavirin (24 weeks) was more effective than shorter durations of treatment (12–16 weeks).