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Managing HCV treatment failure and the potential of resistance testing in informing second-line therapy options

Elisabetta Loggi1, Ranka Vukotic1, Pietro Andreone1

  • 1a Dipartimento di Scienze Mediche e Chirurgiche, Centro Studi e Ricerca sulle Epatiti , Università di Bologna , Bologna , Italy.

Expert Review of Anti-Infective Therapy
|October 20, 2018
PubMed
Abstract

Insights

Direct-acting antivirals are effective for chronic hepatitis C, but resistance testing is crucial for patients who relapse. This helps guide retreatment strategies for better outcomes.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C treatment.
  • A small percentage of patients may relapse after DAA therapy, necessitating careful management.
  • The role of resistance testing in guiding retreatment is currently debated.

Purpose of the Study:

  • To evaluate the impact of resistance-associated substitutions on retreatment outcomes in chronic hepatitis C.
  • To analyze the utility of viral resistance testing in managing DAA treatment failures.

Main Methods:

  • Review of clinical trial data assessing the impact of viral resistance on treatment outcomes.
  • Focus on data from studies involving retreatment of patients with chronic hepatitis C.
  • Evaluation of resistance-associated substitutions in viral sequences.

Main Results:

  • Treatment failure can still occur in chronic hepatitis C patients.
  • Resistance testing is currently a valuable tool for selecting retreatment regimens.
  • Real-world data on relapse rates and management are needed to refine clinical guidelines.

Conclusions:

  • Viral resistance testing aids in choosing retreatment strategies for chronic hepatitis C.
  • Future use of DAAs with higher resistance barriers may reduce the need for resistance testing.
  • Continued research and real-world data are essential for optimizing hepatitis C management.
Keywords:
Chronic hepatitis Cdirect acting antiviralsresistance-associated substitutionstreatment failureviral resistance

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