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Real-life prevalence of resistance-associated variants against non-structural protein 5A inhibitors and efficiency of Daclatasvir + Asunaprevir therapy in Korean patients with genotype 1b hepatitis C.

 Jung Hwan Yu  ;  Jung Il Lee  ;  Kwan Sik Lee  ;  Ja Kyung Kim 
 Virology Journal, Vol.14(164) : 1-9, 2017 
Journal Title
 Virology Journal 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Antiviral Agents/therapeutic use* ; Base Sequence ; Drug Combinations ; Drug Resistance, Viral/drug effects* ; Female ; Genotype ; Hepacivirus/classification* ; Hepacivirus/genetics ; Hepacivirus/isolation & purification ; Hepatitis C, Chronic/drug therapy* ; Hepatitis C, Chronic/epidemiology ; Hepatitis C, Chronic/virology ; Humans ; Imidazoles/therapeutic use* ; Interferons/therapeutic use ; Isoquinolines/therapeutic use* ; Liver Cirrhosis/virology ; Male ; Middle Aged ; Prevalence ; RNA, Viral/isolation & purification ; Republic of Korea ; Sulfonamides/therapeutic use* ; Sustained Virologic Response ; Treatment Failure ; Viral Nonstructural Proteins/drug effects* ; Viral Nonstructural Proteins/genetics*
Asunaprevir ; Chronic hepatitis C ; Daclatasvir ; Direct-acting antivirals
BACKGROUND: Direct-acting antivirals (DAAs) for chronic hepatitis C (CHC) treatment are tolerable and highly effective in a shorter period of time than before. However, resistance-associated variants (RAVs) can affect the efficacy of DAAs. The aim of this study was to investigate the real-life prevalence of RAVs against non-structural protein 5A (NS5A) inhibitors in Korean patients with genotype 1b chronic hepatitis C. METHODS: All consecutive patients with CHC genotype 1b who underwent a RAV test at a single referral hospital were enrolled. RESULTS: A total of 142 patients (male 53, female 89) were tested for RAVs. The average age of the patients was 58 years. Liver cirrhosis was found in 34.5% (49/142) of patients, and 19.0% (29/142) of patients had previously undergone interferon-based treatment. Twenty-nine patients (20.4%) had RAVs (Y93 or L31). Y93H, L31, or Y93H with L31 were detected in 22 (15.5%), 8 (5.6%), and 1 (0.7%) patients, respectively. The presence of RAV was not affected by previous interferon-based treatment or by the existence of liver cirrhosis. Among 113 patients without baseline NS5A RAVs, 72 patients started daclatasvir (DCV) + asunaprevir (ASV) treatment and 95% (68/72) patients achieved virologic response at week 4. Virologic response at end of treatment and sustained virologic response at 12 weeks after treatment were achieved by 94% (68/72) and 94% (68/72), respectively. CONCLUSIONS: In Korean patients with genotype 1b CHC, 20.4% (29 of 142) of patients showed RAVs against NS5A inhibitors. Patient without RAVs who received treatment with DCV + ASV showed high virologic response rates in Korea.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김자경(Kim, Ja Kyung) ORCID logo https://orcid.org/0000-0001-5025-6846
유정환(Yu, Jung Hwan)
이관식(Lee, Kwan Sik) ORCID logo https://orcid.org/0000-0002-3672-1198
이정일(Lee, Jung Il) ORCID logo https://orcid.org/0000-0002-0142-1398
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