Baseline resistance-guided therapy does not enhance the response to interferon-free treatment of HCV infection in real life.

Autor: Real LM; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain. lmreal67b@gmail.com., Macías J; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain., Pérez AB; Servicio de Microbiología, Complejo Hospitalario Universitario de Granada-Hospital PTS, Granada, Spain.; Instituto de Investigación Biosanitaria (IBS), Granada, Spain., Merino D; Unidad de Enfermedades Infecciosas, Hospital Juan Ramón Jiménez, Huelva, Spain., Granados R; Unidad de Enfermedades Infecciosas, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, de Gran Canaria, Spain., Morano L; Unidad de Patología Infecciosa, Hospital Universitario Alvaro Conqueiro. Instituto de Investigación Galicia Sur, Vigo, Spain., Delgado M; Servicio de Enfermedades Infecciosas, Hospital Regional de Málaga, Málaga, Spain., Ríos MJ; Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain., Galera C; Servicio de Medicina Interna, Unidad de VIH. Hospital General Universitario Virgen Arrixaca, Murcia, Spain., Deltoro MG; Unidad de Enfermedades Infecciosas, Consorcio Hospital General Universitario de Valencia, Valencia, Spain., Merchante N; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain., García F; Servicio de Microbiología, Complejo Hospitalario Universitario de Granada-Hospital PTS, Granada, Spain.; Instituto de Investigación Biosanitaria (IBS), Granada, Spain., Pineda JA; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2018 Oct 08; Vol. 8 (1), pp. 14905. Date of Electronic Publication: 2018 Oct 08.
DOI: 10.1038/s41598-018-33367-1
Abstrakt: Hepatitis C virus (HCV) response to direct-acting antivirals (DAAs) may be influenced by the presence of resistance-associated substitutions (RASs). This study aimed to assess if NS5A baseline RAS-guided treatment enhances the rate of sustained viral response (SVR) in naïve HCV-infected patients in clinical practice. All HCV-infected patients who initiated treatment with interferon (IFN)-free DAA-based regimens between March 2016 and May 2017 in 17 Spanish hospitals and who had evaluable SVR 12 weeks (SVR12) after the end of therapy were included. Patients had to be DAA naïve, with the exception of sofosbuvir with/without IFN. In one hospital, participants received therapy guided by the presence of NS5A-RASs (RGT population). Patients enrolled in the remaining hospitals, without baseline RASs testing, constituted the control population. A total of 120 and 512 patients were included in the RGT and control populations, respectively. Nine (7.5%) individuals in the RGT population showed baseline NS5A-RASs. All of them achieved SVR12. The SVR12 rate in the RGT population was 97.2% (three relapses) whereas it was 98.8% (six relapses) in the control population (p = 0.382). Our findings suggest that testing for baseline NS5A-RASs in naïve HCV-infected patients does not enhance the rate of SVR to DAA-based IFN-free therapy in clinical practice.
Databáze: MEDLINE
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