Individualized Treatment of Genotype 1 Naıve Patients: An Italian Multicenter Field Practice Experience

Background: Triple therapy including Telaprevir or Boceprevir still represents in many European countries the standard ofcare for patients with Hepatitis C Virus genotype 1 infection. The number of patients who received this treatment resultedgenerally lower than expected. We investigated, among naı¨ve patients, number and characteristics of treatment candidateswho were started on triple or dual therapy in comparison to those who were deferred.Patients and Methods: 621 naı¨ve treatment candidates were prospectively evaluated at each center. Factors associatedwith decision to defer or treat with dual or triple therapy were investigated by univariate and multivariate analyses. Rates ofSustained Virological Response and safety profile were analysed.Results: Of candidates to treatment, 33% did not received it. It was mostly due to high risk of Interferon-induceddecompensation. Of 397 patients who were started on treatment, 266 (67%) received triple, 131 dual. Among patientreceiving treatment, unfavorable IL28B, severe liver damage and higher albumin were independently associated with thephysician decision to administer triple therapy. Sustained Virological Response after dual therapy was 66.4%, after triple73.7% (p = 0.14). 142 patients received Telaprevir. The choice of Telaprevir-based therapy was associated with higher BodyMass Index and advanced liver disease. Sustained Virological Response rates were 71.1% after Telaprevir and 76.6% afterBoceprevir.Conclusions: Individualizing treatment with available regimens allows to maximize Sustained Virological Response and toreduce the number of patients who remain untreated. High proportion of patients with severe liver damage urgently needInterferon free treatment.