Retreatment of patients with chronic hepatitis C, subtype 3a, and cirrhosis, who previously failed a regimen containing second-generation NS5A inhibitors with sofosbuvir + glecaprevir/pibrentasvir and ribavirin for 16-24 weeks

J Virol. 2025 Feb 25;99(2):e0184324. doi: 10.1128/jvi.01843-24. Epub 2025 Jan 22.

Abstract

The outcomes of retreatment patients infected with hepatitis C virus genotype 3, cirrhosis, with velpatasvir may be affected by treatment failure with velpatasvir. The efficacy of SOF+GLE/PIB+RIB 16-24 weeks of treatment has been shown. The presence of NS5A resistance-associated substitution mutations, including Y93H, and the number and regimens of the past failed therapy do not influence the likelihood of achieving sustained virological response. When velpatasvir treatment fails, pibrentasvir should be used as the first choice for retreatment.

Keywords: antiviral agents; hepatitis C virus; mutation; resistance.

MeSH terms

  • Aminoisobutyric Acids
  • Antiviral Agents* / therapeutic use
  • Benzimidazoles* / therapeutic use
  • Benzopyrans
  • Carbamates / therapeutic use
  • Cyclopropanes
  • Drug Combinations
  • Drug Resistance, Viral / genetics
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepacivirus* / drug effects
  • Hepacivirus* / genetics
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / virology
  • Heterocyclic Compounds, 4 or More Rings / therapeutic use
  • Humans
  • Lactams, Macrocyclic
  • Leucine / analogs & derivatives
  • Liver Cirrhosis* / drug therapy
  • Liver Cirrhosis* / virology
  • Male
  • Middle Aged
  • Proline / analogs & derivatives
  • Pyrrolidines
  • Quinoxalines* / therapeutic use
  • RNA-Dependent RNA Polymerase
  • Retreatment
  • Ribavirin / therapeutic use
  • Sofosbuvir / therapeutic use
  • Sulfonamides / therapeutic use
  • Sustained Virologic Response
  • Treatment Failure
  • Viral Nonstructural Proteins / antagonists & inhibitors
  • Viral Nonstructural Proteins / genetics

Substances

  • Antiviral Agents
  • Sofosbuvir
  • Benzimidazoles
  • Quinoxalines
  • Pyrrolidines
  • Sulfonamides
  • Viral Nonstructural Proteins
  • NS-5 protein, hepatitis C virus
  • Ribavirin
  • glecaprevir and pibrentasvir
  • pibrentasvir
  • Carbamates
  • Proline
  • glecaprevir
  • Heterocyclic Compounds, 4 or More Rings
  • Aminoisobutyric Acids
  • Lactams, Macrocyclic
  • Leucine
  • velpatasvir
  • Benzopyrans
  • Cyclopropanes
  • Drug Combinations
  • RNA-Dependent RNA Polymerase