Yu Jung Hwan, Lee Jung Il, Lee Kwan Sik, Kim Ja Kyung
Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 20, 63-gil, Eonju-ro Gangnam-gu, Seoul, 06229, South Korea.
Virol J. 2017 Aug 24;14(1):164. doi: 10.1186/s12985-017-0826-1.
Direct-acting antivirals (DAAs) for chronic hepatitis C (CHC) treatment are tolerable and highly effective in a shorter period of time than before. However, resistance-associated variants (RAVs) can affect the efficacy of DAAs. The aim of this study was to investigate the real-life prevalence of RAVs against non-structural protein 5A (NS5A) inhibitors in Korean patients with genotype 1b chronic hepatitis C.
All consecutive patients with CHC genotype 1b who underwent a RAV test at a single referral hospital were enrolled.
A total of 142 patients (male 53, female 89) were tested for RAVs. The average age of the patients was 58 years. Liver cirrhosis was found in 34.5% (49/142) of patients, and 19.0% (29/142) of patients had previously undergone interferon-based treatment. Twenty-nine patients (20.4%) had RAVs (Y93 or L31). Y93H, L31, or Y93H with L31 were detected in 22 (15.5%), 8 (5.6%), and 1 (0.7%) patients, respectively. The presence of RAV was not affected by previous interferon-based treatment or by the existence of liver cirrhosis. Among 113 patients without baseline NS5A RAVs, 72 patients started daclatasvir (DCV) + asunaprevir (ASV) treatment and 95% (68/72) patients achieved virologic response at week 4. Virologic response at end of treatment and sustained virologic response at 12 weeks after treatment were achieved by 94% (68/72) and 94% (68/72), respectively.
In Korean patients with genotype 1b CHC, 20.4% (29 of 142) of patients showed RAVs against NS5A inhibitors. Patient without RAVs who received treatment with DCV + ASV showed high virologic response rates in Korea.
用于治疗慢性丙型肝炎（CHC）的直接作用抗病毒药物（DAA）耐受性良好，且在较短时间内比以往更有效。然而，耐药相关变异（RAV）会影响DAA的疗效。本研究的目的是调查韩国1b型慢性丙型肝炎患者中针对非结构蛋白5A（NS5A）抑制剂的RAV的实际流行情况。
纳入在一家转诊医院接受RAV检测的所有连续的1b型CHC患者。
共对142例患者（男性53例，女性89例）进行了RAV检测。患者的平均年龄为58岁。34.5%（49/142）的患者存在肝硬化，19.0%（29/142）的患者既往接受过基于干扰素的治疗。29例患者（20.4%）存在RAV（Y93或L31）。分别在22例（15.5%）、8例（5.6%）和1例（0.7%）患者中检测到Y93H、L31或同时存在Y93H与L31。RAV的存在不受既往基于干扰素的治疗或肝硬化的影响。在113例无基线NS5A RAVs的患者中，72例患者开始接受达卡他韦（DCV）+阿舒瑞韦（ASV）治疗，95%（68/72）的患者在第4周达到病毒学应答。治疗结束时的病毒学应答率和治疗后12周的持续病毒学应答率分别为94%（68/72）和94%（68/72）。
在韩国1b型CHC患者中，20.4%（142例中的29例）的患者显示出针对NS5A抑制剂的RAV。在韩国，接受DCV + ASV治疗且无RAV的患者显示出较高的病毒学应答率。
