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Current Hepatology Reports
Published in: Current Hepatology Reports 1/2017

01-03-2017 | Hepatitis C (J Ahn and A Aronsohn, Section Editors)

Future Paradigms of HCV Management with Resistance Testing

Authors: Lucas A. Hill, David L. Wyles

Published in: Current Hepatology Reports | Issue 1/2017

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Abstract

Purpose of Review

Following an overview of HCV resistance terminology and epidemiology, approaches to managing hepatitis C virus (HCV) resistance-associated substitutions (RASs) are presented according to the HCV treatment regimen being considered, with a focus primarily on NS5A inhibitor-associated RASs.

Recent Findings

Research on the impact of HCV RASs has recently focused on identifying specific patient populations most impacted by the presence of baseline RASs. The available treatment regimens each have unique considerations based on viral and patient specific factors. Effective treatment strategies for the retreatment of patients who have failed DAA regimens are now being evaluated.

Summary

RASs to NS5A inhibitors are the most clinically relevant, particularly in patients with genotypes 1a and 3. The greatest impact of NS5A inhibitor RASs is seen in patients with cirrhosis and/or patients who are treatment experienced. Effective interventions in the setting of resistance include the addition of ribavirin, extension of therapy, and/or selection of alternative HCV treatment regimens. However, the intervention for a given patient will also depend on other factors such as the presence or absence of cirrhosis and the treatment regimen(s) being considered.
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Metadata
Title
Future Paradigms of HCV Management with Resistance Testing
Authors
Lucas A. Hill
David L. Wyles
Publication date
01-03-2017
Publisher
Springer US
Published in
Current Hepatology Reports / Issue 1/2017
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-017-0328-z

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