The current standard of care for patients with chronic hepatitis C virus (HCV) infection is a combination of direct-acting antiviral agents (DAAs). Most HCV patients treated with these drugs achieve viral elimination, but 1% to 15% fail to attain this objective. Treatment failures are usually related to relapse, and less often to on-treatment viral breakthrough. HCV drug resistant associated substitutions are detected in most patients who do not eliminate the virus. The risk of developing these variants depends on host- and virus-related factors, the properties of the drugs used, and the treatment strategies applied. Patients who carry Resistant Associated Substitutions (RASs) may not obtain benefits from treatment, and are at a risk of disease progression. Whether HCV RASs persist depends on their type: NS3-4A variants often disappear gradually after DAA therapy is stopped, whereas NS5A variants tend to persist for more than 2 years. The best way to prevent emergence of resistant variants is to eliminate the virus at the first treatment using highly potent DAAs with genetic barriers to resistance. For those who fail an NS5A inhibitor, deferral of treatment is recommended pending the availability of additional data if they do not have cirrhosis or reasons for urgent re-treatment. If re-treatment is needed, the most commonly used strategy is sofosbuvir as backbone therapy plus a drug from a class other than that previously used, for 24 weeks. Unless it is contraindicated, weight-based ribavirin should also be added. If available, nucleotide-based (eg, sofosbuvir) triple or quadruple DAA regimens may be considered. The optimal treatment for patients who fail an NS5A inhibitor and those with multidrug-resistant variants remains to be defined, and research efforts should continue to focus on treatment for these patients.
Antiviral Agents/*therapeutic use ; Drug Resistance, Viral ; Drug Therapy, Combination ; Genotype ; Hepacivirus/genetics ; Hepatitis C, Chronic/*drug therapy ; Humans ; Recurrence ; Ribavirin/therapeutic use ; Sofosbuvir/therapeutic use

Introduction: This study aimed to determine the effectiveness of basil tea as an adjunct to antihypertensive medications in decreasing the blood pressure of hypertensive subjects. Methods: Hypertensive patients were randomly allocated into either experimental (antihypertensive medications + basil tea) or control (antihypertensive medications alone) group. Experimental subjects drank basil tea twice daily for 28 days, with blood pressure readings done at baseline and on a weekly basis for four weeks. Results : A significant difference in systolic blood pressure was elicited for both treatment (p=0.005) and control (p=0.034) groups. There is a significant difference in the mean systolic (p=0.021) and diastolic blood pressure P (p=0.023) between the two groups at the fourth week in the basil tea group. There was a significant difference (p=0.046) in the mean difference in diastolic blood pressure from baseline to Week 4 in the basil tea group. There was a statistically significant decrease in systolic blood pressure between baseline and Week 4 (p=0.05). Conclusion Basil tea, used as an adjunct to anti-hypertensive medications, elicited a statistically significant reduction in systolic blood pressure and a statistically significant difference in change of diastolic blood pressure after four weeks of treatment.
Ocimum basilicum ; Hypertension