Virological Factors Associated with Failure to the Latest Generation of Direct Acting Agents (DAA) and Re-Treatment Strategy: A Narrative Review

• Published in: Viruses Vol. 13; no. 3; p. 432
• Main Authors: Onorato, Lorenzo, Pisaturo, Mariantonietta, Starace, Mario, Minichini, Carmine, Di Fraia, Alessandra, Astorri, Roberta, Coppola, Nicola
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08.03.2021; MDPI
• Subjects: Antiviral agents; Antiviral Agents - pharmacology; Antiviral Agents - standards; Antiviral Agents - therapeutic use; chronic hepatitis C; Clinical medicine; Clinical Trials as Topic; Cytochrome; DAA; Drug Resistance, Viral - genetics; Drug Therapy, Combination; Genotype & phenotype; Genotypes; Hepacivirus - drug effects; Hepatitis; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C - virology; Humans; Infections; Liver diseases; Mortality; Patients; Proteins; RAS; Retreatment; Review; RNA polymerase; Sustained Virologic Response; Treatment Failure; virological failure; virological failure; DAA; RAS; chronic hepatitis C; retreatment
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v13030432

The availability of all oral direct acting antiviral agents (DAAs) has revolutionized the management of HCV infections in recent years, allowing to achieve a sustained virological response (SVR) in more than 95% of cases, irrespective of hepatitis C Virus (HCV) genotype or staging of liver disease. Although rare, the failure to the latest-generation regimens (grazoprevir/elbasvir, sofosbuvir/velpatasvir, pibrentasvir/glecaprevir) represents a serious clinical problem, since the data available in the literature on the virological characteristics and management of these patients are few. The aim of the present narrative review was to provide an overview of the impact of baseline RASs in patients treated with the latest-generation DAAs and to analyze the efficacy of the available retreatment strategies in those who have failed these regimens.