Hepatitis C virus (HCV) infection is a serious health problem leading to cirrhosis, liver failure and hepatocellular carcinoma. The recent introduction of telaprevir, which was approved in November 2011, in combination with peg-interferon and ribavirin is expected to markedly improve the eradication rate of the virus. However, side effects of triple therapy may be severe. In a phase three III clinical trial, 2250 mg of telaprevir, which is the same dosage used in clinical trials in Western countries, was given to Japanese patients. As this dosage is considered to be relatively high for Japanese patients, who typically have lower weight than patients in Western countries, reduction of telaprevir is recommended in the 2012 revision of the guidelines established by the Study Group for the Standardization of Treatment of Viral Hepatitis Including Cirrhosis published by the Ministry of Health, Labour and Welfare of Japan. Other protease inhibitors with fewer side effects are now in clinical trials in Japan. Alternatively, treatment of patients with combination of direct acting antivirals without interferon has been reported. In this review we summarize current treatment options in Japan and discuss how we treat patients with chronic HCV infection.
Okamoto H, Mishiro S. Genetic heterogeneity of hepatitis C virus. Intervirology. 1994;37:68–76. PubMed
Hadziyannis SJ, Sette H Jr, Morgan TR, et al. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004;140:346–55. PubMed
Schmitz S, O’Leary A, Walsh C, Bergin C, Norris S. The relative efficacy of boceprevir and telaprevir in the treatment of HCV Genotype 1. Clin Infect Dis. 2012. doi: 10.1093/cid/cis880
Liu J, Jadhav PR, Amur S, et al. Response guided telaprevir therapy in prior relapsers?: the role of bridging data from treatment-naive and experienced subjects. Hepatol. 2012. doi: 10.1002/hep.25764
Toyota J, Ozeki I, Karino Y, et al. Virological response and safety of 24-week telaprevir alone in Japanese patients infected with hepatitis C virus subtype 1b. J Viral Hepat. 2012.
Dienstag JL, McHutchison JG. American Gastroenterological Association technical review on the management of hepatitis C. Gastroenterology. 2006;130:231–64 (quiz 214–7).
Akuta N, Suzuki F, Kawamura Y, et al. Predictive factors of early and sustained responses to peginterferon plus ribavirin combination therapy in Japanese patients infected with hepatitis C virus genotype 1b: amino acid substitutions in the core region and low-density lipoprotein cholesterol levels. J Hepatol. 2007;46:403–10. PubMedCrossRef
Suppiah V, Moldovan M, Ahlenstiel G, et al. IL28B is associated with response to chronic hepatitis C interferon-alpha and ribavirin therapy. Nat Genet. 2009; 41:1100–4.
Suzuki F, Ikeda K, Toyota J, et al. Dual oral therapy with the NS5A inhibitor daclatasvir (BMS-790052) and NS3 protease inhibitor asunaprevir (BMS-650032) in HCV genotype 1b-infected null responders or ineligible/intolerant to peginterferon. In: 47th annual meeting of the European Association for the study of the liver (EASL 2012). Barcelona, 2012; Abstract 14.
Sherman KE, Flamm SL, Afdhal NH, et al. Response-guided telaprevir combination treatment for hepatitis C virus infection. N Engl J Med. 2011;365:1014-24.
- Treatment of chronic hepatitis C virus infection in Japan: update on therapy and guidelines
C. Nelson Hayes
- Springer Japan
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