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The Role of RASs /RVs in the Current Management of HCV
The approval of combination therapies with direct-acting antiviral (DAA) regimens has led to significant progress in the field of hepatitis C virus (HCV) treatment. Although most patients treated with these agents achieve a virological cure, resistance to DAAs is a major issue. The rapid emergence o...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539246/ https://www.ncbi.nlm.nih.gov/pubmed/34696525 http://dx.doi.org/10.3390/v13102096 |
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author | Malandris, Konstantinos Kalopitas, Georgios Theocharidou, Eleni Germanidis, Georgios |
author_facet | Malandris, Konstantinos Kalopitas, Georgios Theocharidou, Eleni Germanidis, Georgios |
author_sort | Malandris, Konstantinos |
collection | PubMed |
description | The approval of combination therapies with direct-acting antiviral (DAA) regimens has led to significant progress in the field of hepatitis C virus (HCV) treatment. Although most patients treated with these agents achieve a virological cure, resistance to DAAs is a major issue. The rapid emergence of resistance-associated substitutions (RASs), in particular in the context of incomplete drug pressure, has an impact on sustained virological response (SVR) rates. Several RASs in NS3, NS5A and NS5B have been linked with reduced susceptibility to DAAs. RAS vary based on HCV characteristics and the different drug classes. DAA-resistant HCV variant haplotypes (RVs) are dominant in cases of virological failure. Viruses with resistance to NS3-4A protease inhibitors are only detected in the peripheral blood in a time frame ranging from weeks to months following completion of treatment, whereas NS5A inhibitor-resistant viruses may persist for years. Novel agents have been developed that demonstrate promising results in DAA-experienced patients. The recent approval of broad-spectrum drug combinations with a high genetic barrier to resistance and antiviral potency may overcome the problem of resistance. |
format | Online Article Text |
id | pubmed-8539246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85392462021-10-24 The Role of RASs /RVs in the Current Management of HCV Malandris, Konstantinos Kalopitas, Georgios Theocharidou, Eleni Germanidis, Georgios Viruses Review The approval of combination therapies with direct-acting antiviral (DAA) regimens has led to significant progress in the field of hepatitis C virus (HCV) treatment. Although most patients treated with these agents achieve a virological cure, resistance to DAAs is a major issue. The rapid emergence of resistance-associated substitutions (RASs), in particular in the context of incomplete drug pressure, has an impact on sustained virological response (SVR) rates. Several RASs in NS3, NS5A and NS5B have been linked with reduced susceptibility to DAAs. RAS vary based on HCV characteristics and the different drug classes. DAA-resistant HCV variant haplotypes (RVs) are dominant in cases of virological failure. Viruses with resistance to NS3-4A protease inhibitors are only detected in the peripheral blood in a time frame ranging from weeks to months following completion of treatment, whereas NS5A inhibitor-resistant viruses may persist for years. Novel agents have been developed that demonstrate promising results in DAA-experienced patients. The recent approval of broad-spectrum drug combinations with a high genetic barrier to resistance and antiviral potency may overcome the problem of resistance. MDPI 2021-10-18 /pmc/articles/PMC8539246/ /pubmed/34696525 http://dx.doi.org/10.3390/v13102096 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Malandris, Konstantinos Kalopitas, Georgios Theocharidou, Eleni Germanidis, Georgios The Role of RASs /RVs in the Current Management of HCV |
title | The Role of RASs /RVs in the Current Management of HCV |
title_full | The Role of RASs /RVs in the Current Management of HCV |
title_fullStr | The Role of RASs /RVs in the Current Management of HCV |
title_full_unstemmed | The Role of RASs /RVs in the Current Management of HCV |
title_short | The Role of RASs /RVs in the Current Management of HCV |
title_sort | role of rass /rvs in the current management of hcv |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539246/ https://www.ncbi.nlm.nih.gov/pubmed/34696525 http://dx.doi.org/10.3390/v13102096 |
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