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Future Paradigms of HCV Management with Resistance Testing

  • Hepatitis C (J Ahn and A Aronsohn, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Following an overview of HCV resistance terminology and epidemiology, approaches to managing hepatitis C virus (HCV) resistance-associated substitutions (RASs) are presented according to the HCV treatment regimen being considered, with a focus primarily on NS5A inhibitor-associated RASs.

Recent Findings

Research on the impact of HCV RASs has recently focused on identifying specific patient populations most impacted by the presence of baseline RASs. The available treatment regimens each have unique considerations based on viral and patient specific factors. Effective treatment strategies for the retreatment of patients who have failed DAA regimens are now being evaluated.

Summary

RASs to NS5A inhibitors are the most clinically relevant, particularly in patients with genotypes 1a and 3. The greatest impact of NS5A inhibitor RASs is seen in patients with cirrhosis and/or patients who are treatment experienced. Effective interventions in the setting of resistance include the addition of ribavirin, extension of therapy, and/or selection of alternative HCV treatment regimens. However, the intervention for a given patient will also depend on other factors such as the presence or absence of cirrhosis and the treatment regimen(s) being considered.

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Authors and Affiliations

  1. Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA

    Lucas A. Hill

  2. Division of Infectious Diseases, Denver Health Medical Center, 660 Bannock St., MC 4000, Denver, CO, 80204, USA

    David L. Wyles

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Lucas A. Hill declares no potential conflict of interest.

David L. Wyles reports grants from AbbVie, grants from Bristol Myers Squibb, grants from Gilead, grants from Merck, personal fees from AbbVie, personal fees from Bristol Myers Squibb, personal fees from GIlead, and personal fees from Merck, outside the submitted work.

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Hill, L.A., Wyles, D.L. Future Paradigms of HCV Management with Resistance Testing. Curr Hepatology Rep 16, 1–11 (2017). https://doi.org/10.1007/s11901-017-0328-z

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