Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort
Year: 2019
Type: article
Study design: Observational Study
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.
Source: PLoS ONE
Authors: Ana Belén Pérez, Natalia Chueca, Juan Macías, Juan Antonio Pineda, Javier Salmerón, Antonio Rivero-Juárez, Carmen Hidalgo-Tenorio, María Dolores Espinosa, Francisco Téllez, Miguel Ángel Von-Wichmann, Mohamed Omar, Jesús Santos, José Hernández-Quero, José Joaquin Antón, Antonio Collado, Ana Belén Lozano, Miguel García-Deltoro, Marta Casado, Juan Manuel Pascasio, Aida Selfa, José Miguel Rosales, Alberto De la Iglesia, Juan Ignacio Arenas, Silvia García-Bujalance, María José Ríos, Enrique Bernal, Onofre Martínez, Antonio García-Herola, Mónica Vélez, Pilar Rincón, Federico García
Institutions: Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, Instituto de Investigación Biosanitaria de Granada, Hospital Universitario de Valme, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, University of Córdoba, Hospital Universitario Virgen de las Nieves, Hospital Universitario Puerto Real, Donostiako Unibertsitate Ospitalea, Complejo Hospitalario de Jaén, Hospital Clínico Universitario Virgen de la Victoria, Complejo Hospitalario Torrecárdenas, Hospital de Poniente, Hospital General Universitario De Valencia, Hospital Universitario Virgen del Rocío, Hospital Costa del Sol, Universidad de Huelva, Hospital Universitario La Paz, Hospital Universitario Virgen Macarena, Hospital Reina Sofía de Murcia, Santa Lucía University General Hospital, Hospital Marina Baixa
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,595
OpenAlex ID: W2970340545