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Evaluation of Resistance-Associated Substitutions in NS5A Using Direct Sequence and Cycleave Method and Treatment Outcome with Daclatasvir and Asunaprevir for Chronic Hepatitis C Genotype 1

Tatsuya Ide, Yuichiro Eguchi, Masaru Harada, Kunihide Ishii, Masaru Morita, Yasuyo Morita, Gen Sugiyama, Hirofumi Fukushima, Yoichi Yano, Kazunori Noguchi, Hiroki Nakamura, Junjiro Hisatomi, Hiroto Kumemura, Miki Shirachi, Shinji Iwane, Michiaki Okada, Yuichi Honma, Teruko Arinaga-Hino, Ichiro Miyajima, Kei Ogata, Reiichiro Kuwahara, Keisuke Amano, Toshihiro Kawaguchi, Ryoko Kuromatsu, Takuji Torimura and DAAs Multicenter Study Group

PLOS ONE, 2016, vol. 11, issue 9, 1-11

Abstract: Background: The aim of this study was to evaluate the efficacy of daclatasvir plus asunaprevir therapy in patients infected with hepatitis C virus and determine its relevance to resistant variants. Methods: A total of 629 consecutive patients infected with hepatitis C virus genotype 1 were assessed. Daclatasvir (60 mg/day) plus asunaprevir (200 mg/day) was given for 24 weeks. The virological responses and resistance-associated substitutions of hepatitis C virus mutants were examined by the direct sequence and cycleave methods were evaluated. Results: Overall, 89.4% (555/621) of patients exhibited a sustained virological response (SVR). The SVR rates in the patients with wild type, mixed, and mutant type Y93 by direct sequencing were 92.5% (520/562), 70.3% (26/37), and 42.9% (9/21), respectively. The SVR rates in the patients with 100%, 90%, 80%-30%, and 20%-0% Y93 wild by the cycleave method were 93.4% (456/488), 88.2%(30/34), 56.0%(14/25), and 36.8%(7/19), respectively. In contrast, the SVR rates for the wild type and mixed/mutant type L31 by direct sequencing were 90.2% (534/592) and 72.4% (21/29), respectively. In the multivariate analyses, the wild type Y93, no history of simeprevir therapy, the wild type L31, and low HCV RNA level were independent factors of SVR. Conclusion: NS5A resistance-associated substitutions, especially Y93H, were major factors predicting the SVR. Although direct sequencing can predict the SVR rate, the cycleave method is considered to be more useful for predicting the SVR when used in combination.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0163884

DOI: 10.1371/journal.pone.0163884

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