HCV Drug Resistance Challenges in Japan: The Role of Pre-Existing Variants and Emerging Resistant Strains in Direct Acting Antiviral Therapy

摘要: Sustained virological response (SVR) rates have increased dramatically following the approval of direct acting antiviral (DAA) therapies. While individual DAAs a low barrier to resistance, most patients can be successfully treated using DAA combination therapy. However, are vulnerable drug and resistance-associated variants (RAVs) may occur naturally prior therapy or emerge exposure. RAVs quickly lost in absence DAAs, compensatory mutations reinforce fitness. presence does not necessarily preclude successful treatment. Although developments hepatitis C virus (HCV) Asia largely paralleled those United States, Japan’s July 2014 asunaprevir plus daclatasvir as first all-oral interferon-free was repeated States. Instead, two different therapies were approved: sofosbuvir/ledipasvir paritaprevir/ritonavir/ombitasvir/dasabuvir. This divergence treatment approaches lead differences resistance challenges faced by Japan US. recent sofosbuvir ledipasvir submissions petitions for paritaprevir/ritonavir ombitasvir suggest trend towards new consensus on emerging regimens.