Resistance to hepatitis C virus. Implications and therapeutic options

Gastroenterol Hepatol. 2017 Aug-Sep;40(7):484-494. doi: 10.1016/j.gastrohep.2017.04.007. Epub 2017 Jun 22.
[Article in English, Spanish]

Abstract

We are currently living in an unprecedented era of hepatitis C treatment with the availability of highly effective drugs yielding minimal side effects. The problem we currently face is the retreatment of patients refractory to these drugs. Although several factors can influence treatment failure, this review focuses on antiviral resistance. Resistance-associated substitutions may be identified at baseline or be treatment-emergent. The latter seem to be more clinically relevant and must be studied in the event of treatment failure (no virological response). In this article, we present the latest data from clinical trials and studies in real-life clinical practice. Finally, based on this current evidence, we propose some recommendations for the management and retreatment of these patients.

Keywords: Agentes antivirales directos; Direct-acting antivirals; Fallos a tratamiento; Hepatitis C virus; Resistencia viral; Retratamiento; Retreatment; Treatment failure; Viral resistance; Virus de la hepatitis C.