Retreatment for chronic hepatitis C after drug resistance or treatment failure with daclatasvir-based regimens: report of 3 cases
10.3760/cma.j.cn114015-20201119-01152
- VernacularTitle:含达拉他韦方案治疗慢性丙型肝炎耐药或治疗失败后再治疗3例
- Author:
Hui QUAN
1
;
Yuyong JIANG
;
Hao YU
;
Yixin HOU
Author Information
1. 首都医科大学附属北京地坛医院中西医结合中心，北京 100015
- Publication Type:Journal Article
- Keywords:
Hepatitis C, chronic;
Antiviral agents;
Treatment failure;
Mutation;
Drug resistance, viral;
Retreatment
- From:
Adverse Drug Reactions Journal
2021;23(2):95-98
- CountryChina
- Language:Chinese
-
Abstract:
Three patients (patient 1, a 27-years-old male with chronic hepatitis C; patient 2, a 71-years-old male with hepatitis C complicated by hepatocellular carcinoma; patient 3, a 60-years-old male with hepatitis C decompensated cirrhosis) were treated with daclatasvir-based regimens and developed drug resistance or treatment failure. Patient 1 and patient 2 received daclatasvir combined with asunaprevir. No resistance variants in the non-structural protein (NS) 5A region of HCV were detected in the 2 patients before treatment. In patient 1, HCV RNA levels were both <15 IU/ml at 4 weeks of treatment and when the drug was stopped at 24 weeks of treatment. Ten days after the drug withdrawal, virological breakthrough occurred and HCV sequence analysis showed variants at 4 sites, including S122G, L31V, Y93H, and C316N. In patient 2, HCV RNA was <15 IU/ml at 8 weeks of treatment and virological breakthrough occurred at 12 weeks of treatment. Both patients were given sofosbuvir/velpatasvir combined with ribavirin for 12 weeks and achieved sustained virologic response (SVR). Patient 3 received sofosbuvir combined with daclatasvir for 24 weeks. His HCV RNA levels were all <15 IU/ml at 4 and 12 weeks of treatment and when the drugs were stopped at 24 weeks of treatment. Virological breakthrough appeared at 12 weeks of drug withdrawal. Sofosbuvir/velpatasvir combined with ribavirin were given for 24 weeks and SVR was achieved.
