Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2015; 21(43): 12430-12438
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12430
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12430
Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs
Joshua Hartman, Department of Medicine, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY 10029, United States
Kian Bichoupan, Neal Patel, Sweta Chekuri, Alyson Harty, Douglas Dieterich, Ponni Perumalswami, Andrea D Branch, Division of Liver Disease, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY 10029, United States
Author contributions: Hartman J, Bichoupan K, Perumalswami P and Branch AD designed the research; Hartman J, Bichoupan K, Patel N, Chekuri S, Harty A, Dieterich D, Perumalswami P and Branch AD performed the research; Hartman J, Bichoupan K, Perumalswami P and Branch AD analyzed the data; and Hartman J, Bichoupan K, Perumalswami P and Branch AD wrote the paper.
Supported by The Grants No. R01 DK090317 and No. R01 DA031095 (in part).
Institutional review board statement: The study was reviewed at approved by the Icahn School of Medicine at Mount Sinai Institutional Review Board.
Informed consent statement: Study participants did not provide informed consent prior to study enrollment as the Icahn School of Medicine at Mount Sinai Institutional Review Board provided a waiver of authorization to release deidentified patient data for research purposes.
Conflict-of-interest statement: Kian Bichoupan is a paid consultant for Gilead Sciences and Janssen Pharmaceuticals, Inc. Dr. Andrea D. Branch is a paid consultant for Gilead Sciences and Janssen Pharmaceuticals, Inc. Dr. Douglas T. Dieterich serves as a paid lecturer, consultant and is a member on scientific advisory boards of companies which either develop or assess medicines used for the treatment of viral hepatitis. These companies include Gilead Sciences, Abbvie, Achillion, Bristol-Myers Squibb, Merck, and Janssen Pharmaceuticals, Inc. Alyson Harty is a paid consultant for Abbvie Pharmaceuticals, Gilead Sciences, and Janssen Pharmaceuticals, Inc. Dr. Sweta Chekuri, Dr. Joshua Hartman, Dr. Neal Patel, and Dr. Ponni V. Perumalswmi do not have any disclosures.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at andrea.branch@mssm.edu. Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: 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/
Correspondence to: Andrea D Branch, PhD, Division of Liver Disease, Icahn School of Medicine at the Mount Sinai Medical Center, 11th floor, Room 24, 1425 Madison Avenue, New York, NY 10029, United States. andrea.branch@mssm.edu
Telephone: +1-212-6598371
Received: March 31, 2015
Peer-review started: March 31, 2015
First decision: May 18, 2015
Revised: June 2, 2015
Accepted: July 8, 2015
Article in press: July 8, 2015
Published online: November 21, 2015
Peer-review started: March 31, 2015
First decision: May 18, 2015
Revised: June 2, 2015
Accepted: July 8, 2015
Article in press: July 8, 2015
Published online: November 21, 2015
Core Tip
Core tip: Direct acting antivirals are revolutionizing the treatment of chronic hepatitis C (HCV) infection, but are also increasing the number of patients who have failed multiple rounds of treatment. Information about these patients is needed to plan salvage treatment strategies. We present eight patients who failed treatment with the first generation protease inhibitors and subsequently failed treatment with simeprevir and sofosbuvir. Their shared characteristics include a history of failed treatment with interferon/ribavirin and liver cirrhosis. Seven had genotype 1a HCV and a high viral load. Our findings suggest that patients with cirrhosis and high viral load remain hard-to-treat.