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Genotypic resistance testing of HCV - is there a clinical need?

Andreas Walker1, Rolf Kaiser2, Ralf Bartenschlager3,4

  • 1Institute for Virology, Heinrich-Heine-University, University Hospital, Düsseldorf, Germany.

GMS Infectious Diseases
|January 24, 2019
PubMed

Insights

Direct-acting antivirals (DAAs) offer highly effective hepatitis C virus (HCV) treatment, replacing interferon therapy. This review explores if resistance testing before DAA treatment can optimize outcomes for chronic HCV infections.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Persistent hepatitis C virus (HCV) infection is a significant global health issue.
  • HCV treatment has been revolutionized by direct-acting antivirals (DAAs) in recent years.
  • DAAs target essential viral enzymes like NS3/4A protease, NS5B polymerase, and NS5A.

Purpose of the Study:

  • To review the clinical relevance of resistance-associated substitutions (RASs) in HCV.
  • To evaluate the potential benefit of resistance genotyping before DAA therapy.
  • To optimize the treatment strategies for chronic hepatitis C.

Main Methods:

  • Review of available evidence on DAAs and HCV resistance.
  • Analysis of studies investigating the impact of RASs on DAA efficacy.
  • Discussion of resistance genotyping as a pre-treatment strategy.

Main Results:

  • DAAs demonstrate high efficacy in eliminating HCV, largely replacing interferon-based therapies.
  • The emergence and clinical significance of RASs in the context of DAA treatment require consideration.
  • Resistance genotyping may offer a pathway to personalized HCV treatment optimization.

Conclusions:

  • DAA combinations are highly effective for treating chronic hepatitis C.
  • The role of pre-treatment resistance testing in optimizing DAA therapy warrants further investigation.
  • Understanding RASs is crucial for sustained HCV elimination strategies.
Keywords:
DAAHCVantiviral agentsdirect-acting antiviralhepatitis Cresistanceviral drug resistance

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