Real-world re-treatment outcomes of direct-acting antiviral therapy failure in patients with chronic hepatitis C
| Autor: | Vikas Banyal, Mahendra Singh Rajput, Baibaswata Nayak, Abhinav Anand, Anzar Ashraf, Piyush Pathak, Sonu Kumar, Anshuman Elhence, Ramesh Kumar, Manas Vaishnav, Achintya D. Singh, Dibyabhaba Pradhan, Shalimar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis Sofosbuvir Genotype Hepacivirus Viral Nonstructural Proteins Antiviral Agents Treatment failure 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Chronic hepatitis Virology Internal medicine Drug Resistance Viral medicine Humans 030212 general & internal medicine NS5A Retrospective Studies business.industry Ribavirin Hepatitis C Chronic Middle Aged medicine.disease Infectious Diseases Treatment Outcome chemistry Hepatocellular carcinoma Mutation Retreatment 030211 gastroenterology & hepatology Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Journal of medical virologyREFERENCES. 93(8) |
| ISSN: | 1096-9071 |
| Popis: | Direct-acting antiviral (DAA) drugs are associated with high (>95%) sustained virological response at 12 weeks (SVR12) in chronic hepatitis C (CHC) patients. There is a paucity of data regarding the characteristics and re-treatment outcomes of DAA treatment failure patients. In a retrospective analysis of the prospectively collected database, we assessed the outcomes of re-treatment among patients with previous DAA failure. Patients' characteristics, viral characteristics, including resistance-associated substitutions (RAS) in a subgroup of patients, SVR12, and clinical outcomes were studied. Of 40 patients with DAA failure, among whom 36 were retreated, mean age was 45.7 years, 63.9% (n = 23) were male, 63.9% (n = 23) had a genotype-3 infection and 63.9% (n = 23) were cirrhotic. The re-treatment regimens included a combination of pan-genotypic DAA, mainly sofosbuvir and velpatasvir with or without ribavirin. Three patients who declined retreatment and one who was still on treatment was excluded. For patients who completed re-treatment, SVR12 was 100% irrespective of genotypes. SVR12 among genotype 3 was 75% (15 of 20) when lost to follow-up was considered a treatment failure. Six patients died due to liver-related causes, including five (83.3%) with hepatocellular carcinoma. RAS analysis in 17 randomly selected patients did not reveal any dominant substitutions in NS5A or NS5B region affecting SVR12, though several novel mutations were observed. In conclusion, re-treatment of CHC patients with prior DAA failure using pan-genotypic DAA is associated with high SVR12 rates irrespective of genotype or the presence of RAS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text