2019年9月2日
Management of HCV patients in cases of direct-acting antiviral failure
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
- ,
- ,
- 巻
- 13
- 号
- 9
- 開始ページ
- 839
- 終了ページ
- 848
- 記述言語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1080/17474124.2019.1651642
- 出版者・発行元
- TAYLOR & FRANCIS LTD
Introduction: Over 70 million people are infected with hepatitis C virus (HCV), increasing the risk of cirrhosis and hepatocellular carcinoma. Areas covered: Since the approval of the first interferon-free direct-acting antiviral (DAA) therapy in 2011, a number of DAAs have been approved, and HCV is now considered curable. Until recently, however, there were no clear guidelines on how to re-treat patients who fail DAA therapy. Current protease inhibitors (PIs) are generally unaffected by earlier resistance-associated variants (RAVs), but many NS5A inhibitors continue to have overlapping resistance profiles, and NS5A RAVs can persist even in the absence of DAAs. Expert opinion: Fortunately, RAVs affecting NS5B polymerase inhibitors are rare, making sofosbuvir a safe choice as the backbone of re-treatment therapies. Recent re-treatment guidelines that take into account genotype, fibrosis, treatment history, and RAV suggest that >90% of patients with prior treatment failures can be successfully re-treated with sofosbuvir/velpatasvir, sofosbuvir/velpatasvir/voxilaprevir or glecaprevir/pibrentasvir.
- ID情報
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- DOI : 10.1080/17474124.2019.1651642
- ISSN : 1747-4124