Triple therapy with boceprevir or telaprevir for treatment naïve HCV patients

Boceprevir and telaprevir are the first two protease inhibitors available for the treatment of patients infected with HCV genotype 1. In treatment naïve patients, a sustained virologic response (SVR) of 70-80% is observed when either of these protease inhibitors is used with peginterferon and ribavirin A rapid virologic response (RVR) is observed in 56-60% of them allowing a shorter course of 24-28 weeks of therapy with an excellent SVR rate of 90% or even higher. Patients who do not achieve RVR, and those with cirrhosis should be treated for 48 weeks. Both drugs, boceprevir and telaprevir, achieve similar SVR rates but treatment strategies are completely different for each drug. The decision of which protease inhibitor to utilize should weigh several factors including the treatment strategy, duration of therapy, the likelihood of achieving an RVR, adverse event profile, and cost. Besides, the physician's experience with each drug and the wishes of the patient also have to be considered.