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Antivir Ther. 2019 Feb 13. doi: 10.3851/IMP3296. [Epub ahead of print]

Patients with HCV genotype-1 who have failed a direct-acting antiviral regimen: virological characteristics and efficacy of retreatment.

Author information

1
Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy.
2
Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy.
3
Infectious Diseases Unit, A.O. S Anna and S Sebastiano Caserta, Caserta, Italy.
4
Third Infectious Diseases Unit, AORN dei Colli, P.O. Cotugno, Naples, Italy.
5
Internal Medicine Unit, Evangelical Hospital Villa Betania, Naples, Italy.
6
Internal Medicine Unit A.O Sarno, Sarno (SA)Campania L. Vanvitelli, & Infectious and Transplant Medicine, AORN Ospedali dei Colli- Monaldi Hospital, Naples, Italy.
7
Infectious Diseases Unit, University Federico II, Naples, Italy.
8
HIV Unit, University of Campania L. Vanvitelli, Naples, Italy.
9
Infectious Diseases Unit, A.O S.G. Moscati, Avellino, Italy.
10
Infectious Diseases Unit, A.O G.Rummo, Benevento, Italy.
11
Hepatology Unit, Gragnano Hospital, Gragnano, Italy.
12
Internal Medicine and Hepatology Department of Clinical and Experimental Medicine, University of Campania L. Vanvitelli, Naples, Italy.
13
Internal Medicine and Hepatology Unit, PO G. Da Procida-AOU- San Giovanni and Ruggi D'Aragona, University of Salerno, Salerno Italy.
14
Hepatology Unit, Cardarelli Hospital, Naples, Italy.
15
Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, University of Campania L. Vanvitelli, Naples, Italy.

Abstract

BACKGROUND:

This real-world clinical-setting study characterized the virological patterns in genotype-1 patients failing IFN-free regimens and evaluated the efficacy of re-treatment.

METHODS:

Seventy-three consecutive patients failing IFN-free regimens were enrolled (17 genotype 1a and 56 1b). At failure Sanger sequencing of NS3, NS5A and NS5B regions was performed by home-made protocols.

RESULTS:

In patients having failed an NS3 inhibitor, the prevalence of NS3-RASs was higher in the 10 with genotype 1a than in the 24 with genotype 1b (80% vs. 41.6%). In patients treated with an NS5A inhibitor, the prevalence of NS5A-RASs was very high in the 14 with genotype 1a and the 27 with genotype 1b (78.6% and 92.5%, respectively). In patients having failed sofosbuvir, the prevalence of NS5B-RASs was more frequently identified in the 45 with genotype 1b than in the 10 with genotype 1a (37.7% vs. 10%). The prevalence of NS5B-RASs in patients having failed dasabuvir was high in both genotypes, 66.6% in the 6 with genotype 1a and 45.5% in the 11 with genotype 1b.

CONCLUSIONS:

The prevalence of RASs was high in our real-world population. NS3, NS5A and NS5B sequencing seems mandatory in the choice of DAA re-treatment.

PMID:
30758299
DOI:
10.3851/IMP3296

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