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Introduction When co-administered with interferon and ribavirin, the prescription drug telaprevir significantly improves treatment response in patients with chronic hepatitis C virus (HCV) infection. Its use, however, also increases the likelihood of adverse effects that may lead to discontinuation of treatment. Cutaneous adverse effects are particularly common. Objective To determine the frequency and clinical characteristics of drug eruptions induced by telaprevir in patients receiving HCV treatment and to analyze the clinical course of lesions and response to treatment. Material and methods We performed a prospective observational study of all patients who started a treatment regimen that included telaprevir between May 2012 and July 2013. We recorded the demographic characteristics of the patients who developed telaprevir-induced eruptions, and analyzed the clinical characteristics of the lesions and their clinical course following the application of guideline-based treatment recommendations. Results Twenty (46%) of the 43 patients who received triple therapy with interferon, ribavirin, and telaprevir during the study period developed drug reactions attributable to telaprevir. The reaction was classified as mild or moderate (grades 1 or 2) in 90% of cases and consisted of an exanthem with erythematous-edematous scaling plaques and papules. The rash worsened, mainly by spreading, in about one-third of cases. The skin lesions led to discontinuation of treatment in 2 patients (4.6%). Sustained viral response was achieved in 34 patients (79%). Conclusions Telaprevir-induced eruptions are common and often progress, but they rarely require patients to discontinue treatment.

Introduccion La hepatitis C es una de las causas mas frecuentes de enfermedad hepatica cronica en nuestro medio. La mayoria de los pacientes que presentan una infeccion aguda por el virus de la hepatitis C (VHC) desarrollan hepatitis cronica, y solo entre un 15 y un 30% se resuelven espontaneamente. Pacientes y metodo Se analizaron de forma retrospectiva las caracteristicas clinicas, biologicas y virales, asi como la tolerancia al tratamiento y el grado de repuesta sostenida, en 9 pacientes con hepatitis C aguda tratados con terapia combinada con interferon alfa mas ribavirina durante 12-48 semanas. Resultados La media de alaninaminotransferasa (ALT) y bilirrubina total de los pacientes en el momento del diagnostico fue de 1,469 U/l y 5,5 mg/dl, respectivamente. Todos los pacientes, excepto uno, estaban infectados por el genotipo 1b y presentaban una carga viral media de 634.924 U/ml. Al final del seguimiento, en 7 pacientes (77,7%) los valores de ARN-VHC fueron indetectables y los valores de ALT normales. La terapia fue bien tolerada excepto en 2 pacientes, uno de los cuales presento un sindrome depresivo leve que fue controlado con medicacion, y el otro una tiroiditis que obligo a la interrupcion del tratamiento a las 12 semanas. Conclusiones A pesar de ser una serie reducida de pacientes, el tratamiento combinado con inteferon alfa mas ribavirina parece conseguir una tasa de respuesta sostenida elevada, con una buena tolerancia y escasos efectos secundarios.

983 INCIDENCE OF HEPATOCELLULAR CARCINOMA IN HCV MONOINFECTED AND HIV COINFECTED PATIENTS WHO RECEIVED ANTIVIRAL TREATMENT C. Leal Valdivieso, B. Revollo Barriga, I. Serra Matamala, R.M. Morillas Cunill, M. Sala Llinas, H. Masnou Ridaura, A. Bargallo Garcia, C. Tural Llacher, R. Planas Vila. Hepatology Unit, CIBERehd, Department of Gastroenterology, HIV Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain E-mail: carles.leal@gmail.com