Interferon-free treatment choice according to baseline RASs leads to high SVR rates in HCV genotype 1 infected patients

J Infect Chemother. 2018 Jul;24(7):524-530. doi: 10.1016/j.jiac.2018.02.008. Epub 2018 Apr 5.

Abstract

Aim: Different combinations of direct antiviral agents (DAA) lead to high SVR rates in HCV genotype 1 infected patients. However, presence of baseline resistance-associated substitutions (RASs) represents a major risk factor for treatment failure. It is unknown whether choice of treatment based on RASs has the potential to decrease virologic failure rates.

Methods: Population-based sequencing of NS3 and NS5A genes was performed in HCV genotype 1 infected patients at a German university hospital. Treatment was individually selected based on resistance analyses.

Results: In total, 319 patients (50% treatment-experienced and 30% with cirrhosis) were included. With the treatment choice based on the baseline NS3 and NS5A resistance profile SVR rates between 96 and 100% were observed in all subgroups, including treatment-experienced patients with cirrhosis and HCV genotype 1a infected cirrhotic patients.

Conclusions: The choice of treatment based on the RASs status at baseline may be beneficial for optimizing treatment efficacy in patients with HCV genotype 1 infection and risk factors for treatment failure.

Keywords: Hepatitis C virus; RAS; RAV.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Drug Resistance, Viral / genetics
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Germany
  • Hepacivirus / genetics*
  • Hepatitis C / drug therapy*
  • Hepatitis C / virology
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sustained Virologic Response*
  • Treatment Failure
  • Treatment Outcome
  • Viral Nonstructural Proteins / genetics

Substances

  • Antiviral Agents
  • NS-5 protein, hepatitis C virus
  • NS3 protein, hepatitis C virus
  • Viral Nonstructural Proteins