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Current Hepatology Reports
Published in: Current Hepatology Reports 4/2016

01-12-2016 | Hepatitis C (J Ahn, Section Editor)

Management of Direct-Acting Antiviral Failures in Chronic Hepatitis C Infection

Authors: Kevin Tin, Eiei Soe, James Park

Published in: Current Hepatology Reports | Issue 4/2016

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Abstract

Purpose of review

Direct-acting antiviral agents have revolutionized the treatment for chronic hepatitis C infection with very high cure rates. Treatment failures are commonly due to non-adherence and relapse but less often to viral breakthrough while on therapy. Resistance-associated variants have also emerged to be a culprit for treatment failures. Optimal retreatment regimens in patients who fail direct-acting antiviral agents have been unclear due to limited data.

Recent Findings

In vitro and in vivo studies have suggested that hepatitis C drug-resistant variants undermine direct-acting antiviral-based therapy in patients who do not achieve viral eradication. The risk of developing these variants depends on host- and virus-related factors, the properties of the drugs used, and the treatment strategies applied. The most effective methods in preventing the development of resistant variants include using potent antiviral combinations with high barriers to resistance and reinforcing patient compliance with treatment.

Summary

Despite the effectiveness of direct-acting antiviral agents, patients may fail to attain sustained virologic response and salvage therapy may need to be considered. Therapeutic options are limited and more research needs to be directed towards this select group of patients.
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Metadata
Title
Management of Direct-Acting Antiviral Failures in Chronic Hepatitis C Infection
Authors
Kevin Tin
Eiei Soe
James Park
Publication date
01-12-2016
Publisher
Springer US
Published in
Current Hepatology Reports / Issue 4/2016
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-016-0326-6

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