All patients had the following characteristics: (i) positive for HCV RNA genotype 1 and antibody to HCV (anti-HCV), absence of co-infection with HCV of other genotypes; (ii) negative for hepatitis B surface antigen; (iii) HCV RNA levels of 5.0 log click here IU/mL or more as determined with the COBAS TaqMan HCV test (Roche Diagnostics, Tokyo, Japan); (iv) platelet counts of more than 80 × 103/mm3 without cirrhosis diagnosed by ultrasonography; (v) not pregnant or lactating; (vi) total previous alcohol intake
of less than 500 kg; (vii) absence of HCC, hemochromatosis, Wilson’s disease, primary biliary cirrhosis, alcoholic hepatitis or autoimmune hepatitis; and (viii) absence of antiviral or immunosuppressive treatment during the previous 3 months. Patients were followed for liver function and virological markers at least monthly during treatment and until 24
weeks after completion of the triple therapy. Informed consent was obtained from each patient, and the study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in the a priori approval of the institution’s human research committee. Telaprevir (Telavic; Mitsubishi Tanabe Pharma, Osaka, Japan) was administrated at the dose of 2250 (750 mg three times daily) or 1500 mg/day (750 mg twice daily). We selected 60 patients per group who were matched by age, sex and history of previous IFN-based treatment from the telaprevir 2250 and 1500 mg/day groups (Table 1), because 204 patients
had many differences selleck monoclonal humanized antibody in baseline characteristics in both groups. PEG IFN-α-2b (PEG-Intron; Schering Plough, Kenilworth, NJ, USA) was injected s.c. at a median dose of 1.5 μg/kg (range, 1.1–1.8) once a week. RBV (Rebetol; Schering Plough) was administrated at 200–1000 mg/day; RBV dose of 600 mg/day (for bodyweight ≤60 kg), 800 mg/day (for bodyweight >60 to ≤80 kg) or 1000 mg/day (for bodyweight >80 kg) in principle. Since November 2011, the initial dose of RBV was reduced by 200 mg in cases of female sex, aged 66 years or older, hemoglobin level of less than 13 g/dL, bodyweight of less than 45 kg or platelet counts of less than 上海皓元医药股份有限公司 150 × 103/mm3 at baseline by the judgment of the physician. All participating patients received these three drugs for the initial 12 weeks, followed by PEG IFN and RBV for an additional 12 weeks. All patients were followed up for at least 24 weeks after the last dose of study drugs to assess SVR. Doses of telaprevir, PEG IFN and RBV were reduced or their administration discontinued as required, based on the reduction of hemoglobin levels; reduction of white blood cell, neutrophil or platelet counts; or the development of adverse events. Thus, the total dose of each drug administrated during the 12–24 weeks was calculated as the ratio of the actual administrated total dose to the anticipated total dose of each drug; these ratios provided adherence measures for telaprevir, PEG IFN and RBV.