Individualized DAA Therapy Guided by Resistance Analysis May Improve HCV Treatment Outcomes

Researcher, clipboard, medicine
Researcher, clipboard, medicine
Tailoring treatment based on baseline resistance-associated substitutions status may optimize hepatitis C virus outcomes.

For patients infected with hepatitis C virus (HCV) genotype 1 and with risk factors for treatment failure, tailoring treatment on the basis of baseline resistance-associated substitutions (RASs) status may optimize treatment efficacy, according to results published online in the Journal of Infection and Chemotherapy.

The study included 319 participants with HCV genotype 1 from a German university hospital. The researchers used population-based sequencing of NS3 and NS5A genes on each participant. Treatment was individually selected for each participant on the basis of resistance analysis.

With the treatment choice based on baseline NS3 and NS5A resistance profiles, participants across all subgroups had sustained virologic response (SVR) rates between 96% and 100%.­

Among all participants, the overall SVR rate was 97.5% (n=311/319). In participants without cirrhosis, the SVR rate was 97.8% (n=219/224). For patients with cirrhosis, the SVR rate was 96.8% (n=92/95).

Among treatment-naive participants, the SVR rate was 98.1% (158/161). In treatment-experienced patients, the SVR rate was 96.8% (153/158).

“Our results do not imply a benefit for resistance testing in treatment naïve patients without cirrhosis and in patients infected with HCV subtype 1b. However, resistance testing may help optimize response rates in cirrhotic patients with prior treatment failure and infected with HCV genotype 1a,” the researchers wrote.

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Peiffer K, Vermehren J, Kuhnhenn L, et al. Interferon-free treatment choice according to baseline RASs leads to high SVR rates in HCV genotype 1 infected patients [published online April 5, 2018]. J Infect Chemother. doi: 10.1016/j.jiac.2018.02.008