Retreatment with direct-acting antivirals of genotypes 1-3-4 hepatitis C patients who failed an anti-NS5A regimen in real world

Abstract Introduction The aim was to study retreatment according to baseline nonstructural protein 5A (NS5A) resistance-associated substitutions (RASs) after the failure of first-line DAA-based treatment. Patients and Methods From January 2014 to March 2016, 2995 HCV-infected patients were treated with NS5A inhibitors in six French liver referral centers; 80 (2.7%) patients relapsed. This “real-world” study included 24 of those 80 patients who had failed to achieve sustained virological response (SVR) on previous NS5A-based therapy. These 24 patients were re-treated with different regimen combinations. Antiviral efficacy was evaluated using the primary endpoints of SVR at weeks 4 and 12 post-treatment (SVR4, SVR12). Results The presence of NS5A RASs/polymorphisms was found in 20 (80%) patients at baseline of retreatment. All patients achieved SVR with HCV RNA below the lower limit of quantification ( Conclusions Based on these results, retreatment of patients after the failure of a first-line NS5A regimen is effective (96% SVR). In the future, either dual or triple therapy regimens may have similar results with shorter treatment duration.