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  4. Drug Resistance Profile and Clinical Features for Hepatitis C Patients Experiencing DAA Failure in Taiwan
 
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Drug Resistance Profile and Clinical Features for Hepatitis C Patients Experiencing DAA Failure in Taiwan

Journal
Viruses
Journal Volume
13
Journal Issue
11
Pages
2294
Date Issued
2021-11
Author(s)
CHUN-MING HONG  
Lin, You-Yu
CHUN-JEN LIU  
Lai, Ya-Yun
Shiou-Hwei Yeh  
HUNG-CHIH YANG  
JIA-HORNG KAO  
SHIH-JER HSU  
Huang, Yi-Hsiang
Yang, Sheng-Shun
Kuo, Hsing-Tao
Cheng, Pin-Nan
Yu, Ming-Lung
PEI-JER CHEN  
DOI
10.3390/v13112294
URI
https://scholars.lib.ntu.edu.tw/handle/123456789/623059
URL
https://scholars.lib.ntu.edu.tw/handle/123456789/592981
Abstract
About 4% of the population in Taiwan are seropositive for anti-HCV Ab and 70% with HCV RNA. To address this high chronic hepatitis C disease load, Taiwan National Health Insurance started reimbursing genotype-specific DAAs in 2017 and pangenotype DAAs in mid-2018. With a 97% SVR12 rate, there were still 2-3% of patients that failed to clear HCV. To understand the causes of DAA failure in Taiwan, we conducted a multi-center, clinical, and virologic study. A total of 147 DAA-failure patients were recruited, and we searched HCV NS3/4A, NS5A and NS5B for known resistance-associated substitutions (RASs) by population sequencing, and conducted whole genome sequencing (WGS) for those without known RASs. A total of 107 patients received genotype-specific DAAs while 40 had pangenotype DAAs. Clinically, the important cause of failure is poor adherence. Virologically, common RASs in genotype-specific DAAs were NS5A-L31, NS5A-Y93, and NS5B-C316, while common RASs in pangenotype DAAs were NS5A-L31, NS5A-A/Q/R30, and NS5A-Y93. Additionally, new amino acid changes were found by WGS. Finally, we identified 12 cases with inconsistent baseline and post-treatment HCV genotypes, which is suggestive of re-infection rather than treatment failure. Our study described the drug resistance profile for DAA failure in Taiwan, showing differences from other countries.
Subjects
Taiwan; chronic hepatitis C; direct-acting antiviral agent; resistance-associated substitution; treatment failure; whole genome sequencing
Publisher
MDPI
Type
journal article

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To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of “NTU Repository” with “Academic Hub” to form NTU Scholars.

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