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

This real-world clinical setting study characterized the virological patterns in genotype-1 patients failing interferon (IFN)-free regimens and evaluated the efficacy of re-treatment. A total of 73 consecutive patients failing IFN-free regimens were enrolled (17 genotype-1a and 56 -1b). At failure S...

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Veröffentlicht in:Antiviral therapy 2019-01, Vol.24 (7), p.485-493
Hauptverfasser: Pisaturo, Mariantonietta, Starace, Mario, Minichini, Carmine, De Pascalis, Stefania, Macera, Margherita, Occhiello, Laura, Messina, Vincenzo, Sangiovanni, Vincenzo, Claar, Ernesto, Precone, Davide, Stornaiuolo, Gianfranca, Stanzione, Maria, Gentile, Ivan, Brancaccio, Giuseppina, Martini, Salvatore, Masiello, Addolorata, Megna, Angelo Salomone, Coppola, Carmine, Federico, Alessandro, Sagnelli, Evangelista, Persico, Marcello, Lanza, Alfonso Galeota, Marrone, Aldo, Gaeta, Giovanni Battista, Coppola, Nicola
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Sprache:eng
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Zusammenfassung:This real-world clinical setting study characterized the virological patterns in genotype-1 patients failing interferon (IFN)-free regimens and evaluated the efficacy of re-treatment. A total of 73 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. 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% versus 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% versus 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. The 6 patients re-treated with genotype-1a less frequently (50%) showed sustained virological response (SVR) than the 18 with genotype-1b (88.8%; P=0.07). SVR was more frequent in the 21 patients with an effective second-line direct-acting antiviral (DAA) regimen than the 3 without (90.4% versus 0%; P
ISSN:1359-6535
2040-2058
DOI:10.3851/IMP3296