Resistance-associated substitutions after sofosbuvir/velpatasvir/voxilaprevir triple therapy failure.
作者： Francisco Rodriguez‐Frias , Ramiro Macenlle , David Tabernero , Angeles Castro‐Iglesias , Angelina Cañizares
DOI: 10.1111/JVH.13497
关键词:
摘要: Direct acting-antivirals (DAAs) resolve chronic HCV infection in >95% of patients, but a small percentage do not respond to DAA-based therapy. These may be difficult treat because resistance-associated substitutions (RAS) emerging after treatment failure. Triple therapy with sofosbuvir(SOF)/velpatasvir(VEL)/voxilaprevir(VOX) is the recommended retreatment However, rare cases, failure triple occurs, and there little information characterizing viruses that relapse. To determine RAS profile failing SOF/VEL/VOX, seek suitable alternatives for retreatment, samples from 5 patients were analyzed using MiSeq Illumina deep-sequencing before All men, aged 59-78 years, 2 genotype (G) 1b 3 G3a. The most prevalent NS3 SOF/VEL/VOX Y56F A166T. Four had NS5A RAS, Y93H, failure, Y93H was observed both G1b SOF/ledipasvir In G3a appeared at other G3a, A30K persisted 100% viral genomes. Finally, showed C316N NS5B, associated SOF no known NS5B substitutions. analysis identified following present higher rates failure: (G1b), A166T (G3a), or NS5A, (G1b). A RAS-based salvage (SOF+glecaprevir/pibrentasvir+RBV) successfully used one patient.
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