Prevalence of Drug Resistance Associated Substitutions in Persons With Chronic Hepatitis C Infection and Virological Failure Following Initial or Re-treatment With Pan-genotypic Direct-Acting Antivirals: A Systematic Review and Meta-analysis.

Autor:	Inzaule S; Amsterdam Institute for Global Health and Development, and Department of Global Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Easterbrook P; HIV, Hepatitis and Sexually Transmitted Infection Department, World Health Organization, Geneva, Switzerland., Latona A; Division of Geographic Medicine and Infectious Diseases,Tufts University School of Medicine, Boston, Massachusetts, USA., Ford NP; HIV, Hepatitis and Sexually Transmitted Infection Department, World Health Organization, Geneva, Switzerland., Irving W; School of Life Sciences, Division of Microbiology and Infectious Diseases, The University of Nottingham, Nottingham, United Kingdom., Matthews PC; The Francis Crick Institute, London, United Kingdom., Vitoria M; HIV, Hepatitis and Sexually Transmitted Infection Department, World Health Organization, Geneva, Switzerland., Duncombe C; International Association of Providers of AIDS Care, Washington, DC, USA., Giron A; Independent Consultant, Guatemala city, Guatemala., McCluskey S; Division of Infectious Diseases, Havard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA., Lesi O; HIV, Hepatitis and Sexually Transmitted Infection Department, World Health Organization, Geneva, Switzerland., Tchamgoue S; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon., Halford R; World Hepatitis Alliance, Geneva, Switzerland., Adda D; World Hepatitis Alliance, Geneva, Switzerland., Thomson E; Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom., Dusheiko G; Institute for Global Health, University College London, London, United Kingdom., Jordan MR; Division of Geographic Medicine and Infectious Diseases,Tufts University School of Medicine, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2024 Dec 17; Vol. 79 (6), pp. 1437-1446.
DOI:	10.1093/cid/ciae431
Abstrakt:	Background: The advent of short-course, curative treatment with direct-acting antivirals (DAA) has given promise for the global elimination of hepatitis C virus (HCV) infections by 2030. Virological failure occurs in 2%-12% of persons receiving curative DAA treatment and may be presaged by pre-existing polymorphisms or result from selection of drug resistant variants during therapy. Methods: We conducted a systematic review to assess the prevalence of HCV resistance associated substitutions (RAS) among individuals with chronic hepatitis C infection who had virological failure following initial or re-treatment with pan-genotypic DAA regimens. We included 34 and 22 studies assessing RAS in people with virological failure published between January 2014 and July 2023. Pooled RAS prevalence was estimated using random-effects meta-analysis. Results: The pooled prevalence of RAS in people with virological failure following initial DAA treatment was 78.0% (95% confidence interval [CI]: 62.0-92.0) for sofosbuvir/velpatasvir, 81.0% (95% CI: 67.0-93.0) for sofosbuvir/daclatasvir, and 79.0% (95% CI: 70.0-87.0) for glecaprevir/pibrentasvir, with a high prevalence of resistance to the NS5A inhibitors. Among those with virological failure following re-treatment regimens, RAS were present in 93.0% (95% CI: 83.0-99.0) for sofosbuvir/velpatasvir/voxilepravir and in 100% (95% CI: 92.0-100) for glecaprevir/pibrentasvir, with resistance driven by RAS to NS5A inhibitors. Discussion: At least 1 RAS is present in a high proportion of the few individuals with virological failure following initial or re-treatment with pan-genotypic DAA regimens. There is a need for ongoing surveillance for DAA-associated resistance, to assess risk factors for their development and clinical impact to inform best practice strategies for re-treatment. Competing Interests: Potential conflicts of interest. W. I. reports personal fees from Roche diagnostics, Gilead Sciences, and Source Bioscience Limited outside of the submitted work and stock or stock options in GlaxoSmithKline. P. C. M. reports funding from Francis Crick Institute and University College London Biomedical Research Centre (BRC) and Wellcome Trust during the submitted work, as well as royalties from Oxford University Press and funding from GlaxoSmithKline outside of the submitted work. S. T. reports funding or personal fees ViiV Healthcare and Gilead Sciences outside of the submitted work. D. A. reports funding from Gilead Sciences and Pfizer outside of the submitted work. R. H. serves as the president of World Hepatitis Alliance. All other authors declare no competing interests. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
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