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Telaprevir
Jan 15, 2010

Thank you, Dr. McGovern, for all you do for individuals living with HIV/HCV!

A couple questions about the new HCV protease inhibitor(s):

1) Once Telaprevir is (hopefully) approved, do you believe it will be used in first-line therapy for HCV? Specifically, in genotype 1 treatment-naive patients, will the automatic standard of care become interferon+ribavirin+telaprevir? Or will clinicians continue to use just interferon+ribavirin at first, and reserve the protease inhibitor only for non-responders?

2) I know the percentage of genotype 1 patients who achieve SVR when treated with interferon+ribivirin is about 50% (good, for sure, but not great). How much do you think the addition of Telaprevir to standard therapies could improve the SVR rate among treatment-naive patients with genotype 1 virus? Are there any data addressing this? With Telaprevir, I'm really hoping that the SVR rate for treatment-naive genotype 1 patients will be significantly higher than the current 50% statistic. With the addition of Telaprevir, what percent of this population do you think could potentially achieve SVR (assuming they adhere to treatment)?

Thank you so much!

Response from Dr. McGovern

Excellent question.

Yes, tHese are very exciting times for the treatment of HCV. Although it will be important to wait to hear the full review of all the data by the FDA, the information that have been discussed at major meetings and some of the published articles suggest that triple therapy will become the new standard of care for treatment naive patients with genotype 1 infection. This is due to the better overall responses; furthermore, the use of telaprevir can shorten the duration of treatment to 24 weeks in HCV infected patients.

We will need to await trial information about the use of this drug in HIV/HCV coinfected patients, but I am very hopeful for good outcomes as well since this is a potent therapy with excellent antiviral activity against HCV. Stay tuned.



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