Very short course of triple therapy including telaprevir for chronic hepatitis C: a possible strategy in selected patients

The recent introduction of direct antiviral agents (DAAs) as a fundamental part of anti-hepatitis C virus (HCV) therapy has dramatically improved the possibility of cure for patients with genotype 1, but at the same time it has increased the incidence of severe adverse events and the risk of reduced compliance. Here we present the case of a 72-year-old Caucasian male suffering from a genotype-1b HCV infection, with a previous history of virological breakthrough at the end of dual therapy with pegylated interferon and ribavirin at standard dosages. The patient was retreated with telaprevir-based triple therapy, and despite of the early spontaneous interruption of treatment because of severe anemia and fatigue, he obtained sustained virological response the same. This case suggests that in selected genotype-1 HCV-infected patients, primarily with the subtype 1b, who require the interruption of anti-HCV therapy because of severe adverse events or reduced compliance, a successful treatment can be obtained even with a very short course of DAA-based triple therapy.