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- Title
Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort.
- Authors
Pérez, Ana Belén; Chueca, Natalia; Macías, Juan; Pineda, Juan Antonio; Salmerón, Javier; Rivero-Juárez, Antonio; Hidalgo-Tenorio, Carmen; Espinosa, María Dolores; Téllez, Francisco; Von-Wichmann, Miguel Ángel; Omar, Mohamed; Santos, Jesús; Hernández-Quero, José; Antón, José Joaquin; Collado, Antonio; Lozano, Ana Belén; García-Deltoro, Miguel; Casado, Marta; Pascasio, Juan Manuel; Selfa, Aida
- 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.
- Subjects
SPAIN; CHRONIC hepatitis C; EUROPEAN Union; HEPATITIS C; HEPATITIS B; RIBAVIRIN; PHYSICIANS; MEDICAL microbiology; DISEASE prevalence
- Publication
PLoS ONE, 2019, Vol 14, Issue 8, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0221231