Use of boceprevir and telaprevir in patients with hepatitis C virus infection (practical considerations)

The European Medicines Agency has recently approved the use of telaprevir (Incivo (R), Janssen) and boceprevir (Victrelis (R), MSD) combined with pegylated interferon and ribavirin in triple therapy as the treatment of choice in patients with genotype 1 chronic hepatitis C infection. The high efficacy of triple therapy, even in patients with cirrhosis or those previously unresponsive to pegylated interferon and ribavirin, represents a major step forward in the management of chronic hepatitis C infection. However, in routine clinical practice, triple therapy poses a major challenge requiring detailed knowledge of various aspects that differ substantially from the standard therapy of hepatitis C infection with pegylated interferon and ribavirin. These aspects include the profile and management of the most common adverse effects, the most important drug interactions, and the importance of respecting the guidelines for treatment withdrawal. (C) 2011 Elsevier Espana, S.L. and AEEH y AEG. All rights reserved.