Ridruejo E, Pereson MJ, Flichman DM, Di Lello FA. Hepatitis C virus treatment failure: Clinical utility for testing resistance-associated substitutions. World J Hepatol 2021; 13(9): 1069-1078 [PMID: 34630875 DOI: 10.4254/wjh.v13.i9.1069]
Corresponding Author of This Article
Federico Alejandro Di Lello, PhD, Research Scientist, Teacher, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Junin 9564 Piso, RA-1113 Buenos Aires, Ciudad Autónoma de Buenos Aires 1113, Argentina. fadilello@ffyb.uba.ar
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2021; 13(9): 1069-1078 Published online Sep 27, 2021. doi: 10.4254/wjh.v13.i9.1069
Hepatitis C virus treatment failure: Clinical utility for testing resistance-associated substitutions
Ezequiel Ridruejo, Matías Javier Pereson, Diego M Flichman, Federico Alejandro Di Lello
Ezequiel Ridruejo, Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Ciudad Autónoma de Buenos Aires C1425AS, Unspecified, Argentina
Matías Javier Pereson, Federico Alejandro Di Lello, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires 1113, Argentina
Diego M Flichman, Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida (INBIRS), Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires 1113, Argentina
Author contributions: Ridruejo E and Di Lello FA designed and wrote the manuscript; Pereson MJ and Flichman DM wrote the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Federico Alejandro Di Lello, PhD, Research Scientist, Teacher, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Junin 9564 Piso, RA-1113 Buenos Aires, Ciudad Autónoma de Buenos Aires 1113, Argentina. fadilello@ffyb.uba.ar
Received: February 22, 2021 Peer-review started: February 22, 2021 First decision: May 3, 2021 Revised: May 12, 2021 Accepted: August 10, 2021 Article in press: August 10, 2021 Published online: September 27, 2021
Abstract
The hepatitis C virus has a high mutation capacity that leads to the emergence of resistance-associated substitutions (RAS). However, the consequence of resistance selection during new direct-acting antiviral drug (DAA) treatment is not necessarily the therapeutic failure. In fact, DAA treatment has shown a high rate (> 95%) of sustained virological response even when high baseline RAS prevalence has been reported. In the context of RAS emergence and high rates of sustained viral response, the clinical relevance of variants harboring RAS is still controversial. Therefore, in order to summarize the data available in international guidelines, we have reviewed the clinical utility of testing RAS in the era of new pangenotypic DAA drugs.
Core Tip: The presence of resistance-associated substitutions (RAS) to hepatitis C virus (HCV) treatment is a frequent event. Direct-acting antiviral (DAA) treatment represents a milestone in the antiviral therapy of chronic HCV infection. The role of RAS in sustained virological response remains controversial. We herein discuss the clinical utility of testing RAS in the era of pangenotypic DAA drugs.
