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Re-treatment for Patients with NS5A Resistant-Associated Variants of Hepatitis C Virus: A Review of Clinical Effectiveness

Published on: July 28, 2016
Project Number: RC0798-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of re-treatment in patients with NS5A resistance-associated variants of hepatitis C virus who have failed on treatment with NS5A inhibitors?

Key Message

One low quality study9 showed that 12 weeks therapy with a combination regimen of sofosbuvir (SOF) and simeprevir (SIM) was an effective retreatment in chronic HCV GT 1 or 4 patients who had failed a previous daclatasvir (DCV)-based regimen. The SVR12 rate in patients with NS5A RAVs was 84.6%, whereas the overall SVR12 was 87.5%. Another low quality study10 found that retreatment with a combination of ledipasvir (LDV) and SOF for 12 weeks was effective retreatment in HCV-infected patients with early-stage hepatic fibrosis who had previously failed a short-course (4 or 6 weeks) of combination therapy containing LDV/SOF. The SVR12 in patients with NS5A RAVs was 89.7% whereas the overall SVR12 was 91%. A third low quality study11 showed that the addition of ribavirin (RBV) to a combination therapy with LDV and SOF for 24 weeks was effective retreatment for patients who had failed 12 weeks initial treatment with LDV/SOF combination alone. The SVR12 in patients with NS5A RAVs was 86% whereas the overall SVR12 was 89%.

Tags

drug resistance, genes, genetics, genotype, hepatitis c, infectious diseases, mutation, Viral, daclatasvir, elbasvir, ledipasvir, odalasvir, ombitasvir, ravidasvir, samatasvir, velpatasvir