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© 2019 Pérez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Treatment guidelines differ in their recommendation to determine baseline resistance associated substitutions (RAS) before starting a first-line treatment with direct-acting antivirals (DAAs). Here we analyze the efficacy of DAA treatment with baseline RAS information. We conducted a prospective study involving 23 centers collaborating in the GEHEP-004 DAA resistance cohort. Baseline NS5A and NS3 RASs were studied by Sanger sequencing. After issuing a comprehensive resistance report, the treating physician decided the therapy, duration and ribavirin use. Sustained virological response (SVR12) data are available in 275 patients. Baseline NS5A RAS prevalence was between 4.3% and 26.8% according to genotype, and NS3 RASs prevalence (GT1a) was 6.3%. Overall, SVR12 was 97.8%. Amongst HCV-GT1a patients, 75.0% had >800,000 IU/ml and most of those that started grazoprevir/elbasvir were treated for 12 weeks. In genotype 3, NS5A Y93H was detected in 9 patients. 42.8% of the HCV-GT3 patients that started sofosbuvir/velpatasvir included ribavirin, although only 14.7% carried Y93H. The efficacy of baseline resistance-guided treatment in our cohort has been high across the most prevalent HCV genotypes in Spain. The duration of the grazoprevir/elbasvir treatment adhered mostly to AASLD/IDSA recommendations. In cirrhotic patients infected with GT-3 there has been a high use of ribavirin.

Details

Title
Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort
Author
Pérez, Ana Belén; Chueca, Natalia; Macías, Juan; Pineda, Juan Antonio; Salmerón, Javier; Rivero-Juárez, Antonio; Hidalgo-Tenorio, Carmen; Espinosa, María Dolores; Téllez, Francisco; Von-Wichmann, Miguel Ángel; Omar, Mohamed; Santos, Jesús; Hernández-Quero, José; Antón, José Joaquin; Collado, Antonio; Lozano, Ana Belén; García-Deltoro, Miguel; Casado, Marta; Pascasio, Juan Manuel; Selfa, Aida; José Miguel Rosales; De la Iglesia, Alberto; Arenas, Juan Ignacio; García-Bujalance, Silvia; Ríos, María José; Bernal, Enrique; Martínez, Onofre; García-Herola, Antonio; Vélez, Mónica; Rincón, Pilar; García, Federico
First page
e0221231
Section
Research Article
Publication year
2019
Publication date
Aug 2019
Publisher
Public Library of Science
e-ISSN
19326203
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2282980146
Copyright
© 2019 Pérez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.