Genotype 1 HCV Infection
ÎThe optimal therapy for genotype 1, chronic HCV infection is the use of boceprevir or telaprevir in combination with PegIFN alfa and RBV (I-A).
ÎBoceprevir and telaprevir should weight-based RBV (I-A).
be used without PegIFN alfa and
> The dose for PegIFN alfa-2a is 180 mcg subcutaneously per week together with RBV using doses of 1000 mg for those ≤ 75 kg in weight and 1200 mg for those > 75 kg.
> The dose for PegIFN alfa-2b is 1.5 mcg/kg subcutaneously per week together with RBV using doses of 800 mg for those weighing < 65 kg, 1000 mg for those weighing > 65 kg to 85 kg, 1200 mg for > 85 kg to 105 kg, and 1400 mg for > 105 kg.
For Treatment-Naïve Patients
ÎPatients with cirrhosis treated with either boceprevir or telaprevir in combination with PegIFN and RBV should receive therapy for a duration of 48 weeks. (IIb-B)
Boceprevir
ÎThe recommended dose of boceprevir is 800 mg administered with food three times per day (every 7-9 hours) together with PegIFN alfa and weight-based RBV for 24-44 weeks preceded by 4 weeks of lead-in treatment with PegIFN alfa and RBV alone (I-A).
ÎFor patients without cirrhosis treated with boceprevir, PegIFN and RBV, preceded by 4 weeks of lead-in PegIFN and RBV, whose HCV RNA level at weeks 8 and 24 is undetectable, consider a shortened duration of treatment of 28 weeks in total (4 weeks lead-in with PegIFN and RBV followed by 24 weeks of triple therapy) (IIa-B).
ÎStop treatment with all three drugs (boceprevir, PegIFN alfa and RBV) if the HCV RNA level is > 100 IU/mL at treatment week 12 or detectable at treatment week 24 (IIa-B).
Telaprevir
ÎThe recommended dose of telaprevir is 750 mg administered with food (not low fat) three times per day (every 7-9 hours) together with PegIFN alfa and weight-based RBV for 12 weeks followed by an additional 12-36 weeks of PegIFN alfa and RBV (I-A).
ÎFor patients without cirrhosis treated with telaprevir, PegIFN and RBV, whose HCV RNA level at weeks 4 through 12 is undetectable, consider a shortened duration of 24 weeks (IIa-A).
ÎStop treatment with all three drugs (telaprevir, PegIFN alfa and RBV) if the HCV RNA level is > 1000 IU/mL at treatment weeks 4 or 12 and/or detectable at treatment week 24 (IIa-B).
3
N
OT