Pérez Ana Belén, Chueca Natalia, García Federico
PhD, Clinical Microbiology Department; Infectious Diseases & Clinical Microbiology Unit. Hospital Universitario San Cecilio, Instituto de Investigaciόn Ibs.Granada, Av. de la Innovaciόn S/N, 18016, Granada, Spain.
Germs. 2017 Mar 1;7(1):40-44. doi: 10.18683/germs.2017.1107. eCollection 2017 Mar.
The need to test for resistance associated substitutions (RAS) has been intensively debated in the past two years. In the absence of pangenotypic combinations, it seems reasonable that, if available, RAS testing in the NS5A gene at baseline for genotypes 1a and 3 may help to avoid overtreatment in terms of ribavirin usage and/or prolonged treatment duration. When patients fail treatment, RAS testing may also be useful to guide the selection of the new regimen, especially for those that need urgent retreatment and that have failed a combination including an NS5A inhibitor. However, there are new drugs in the pipeline that in combination are pangenotypic, very potent and with a high genetic barrier to resistance. In this new scenario, RAS testing may not play such an important role.
在过去两年中，针对与耐药相关的替代位点（RAS）进行检测的必要性一直存在激烈争论。在缺乏泛基因型联合治疗方案的情况下，如果可行，对于1a型和3型基因型在基线时检测NS5A基因中的RAS，在避免利巴韦林使用方面的过度治疗和/或延长治疗疗程方面似乎是合理的。当患者治疗失败时，RAS检测对于指导新治疗方案的选择也可能有用，特别是对于那些需要紧急重新治疗且对包含NS5A抑制剂的联合治疗方案治疗失败的患者。然而，有一些正在研发中的新药，它们联合使用时具有泛基因型、强效且耐药基因屏障高的特点。在这种新情况下，RAS检测可能不会发挥如此重要的作用。
