Mechanisms of Hepatitis C Viral Resistance to Direct Acting Antivirals

Viruses

Asma Ahmed¹  Daniel J. Felmlee² 

[1] Plymouth University, Peninsula School of Medicine and Dentistry, Plymouth PL6 8BU, UK;;Plymouth University, Peninsula School of Medicine and Dentistry, Plymouth PL6 8BU, UK

关键词: resistance;    hepatitis C;    direct acting antivirals;    breakthrough variants;   

DOI  :  10.3390/v7122968

来源: mdpi

【 摘 要 】

There has been a remarkable transformation in the treatment of chronic hepatitis C in recent years with the development of direct acting antiviral agents targeting virus encoded proteins important for viral replication including NS3/4A, NS5A and NS5B. These agents have shown high sustained viral response (SVR) rates of more than 90% in phase 2 and phase 3 clinical trials; however, this is slightly lower in real-life cohorts. Hepatitis C virus resistant variants are seen in most patients who do not achieve SVR due to selection and outgrowth of resistant hepatitis C virus variants within a given host. These resistance associated mutations depend on the class of direct-acting antiviral drugs used and also vary between hepatitis C virus genotypes and subtypes. The understanding of these mutations has a clear clinical implication in terms of choice and combination of drugs used. In this review, we describe mechanism of action of currently available drugs and summarize clinically relevant resistance data.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.