Management of DAAs Failure

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Summary • Treatment-emergent RAV(S) seen in treatment failure and in all DAA classes and rarely with SOF • NS3 RAVs have low replication efficacy and disappear over 9-18 mos • If considering SMV + SOF: In treatment-naive and treatment-experienced pts with both genotype 1a HCV infection and compensated cirrhosis, ensure no Q80K • NS5A treatment-emergent RAVs persistent and a clinical challenge • If failure with any NS5A inhibitors , and treatment is urgent, test for NS3 and NS5A RAVs • Use SMV + SOF + RBV if NS5A but no NS3 RAVs • Use LDV/SOF orDacla + RBV if no NS5A RAVs • Treat in clinical trial if both NS5A and NS3 RAVs present
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Page 2 and 3: Management of DAAs Failure Prof. Ga
Page 4 and 5: • HCV is an enveloped, positive-s
Page 6 and 7: Antiviral Resistance • Each patie
Page 8 and 9: All DAAs Can Select Resistant Varia
Page 10 and 11: Barrier to Resistance Low-barrier d
Page 13: NS5B RAV(S) • Sofosbuvir has a hi
Page 16 and 17: Protease inhibitor-Resistant Viruse
Page 18 and 19: SVR12 (%) 24 Wks of LDV/SOF Retreat
Page 20 and 21: DAA Treatment Failure •Relapse or
Page 22 and 23: Treatment recommendations for retre
Page 24 and 25: A- Retreatment of patients with pre
Page 26 and 27: A- Retreatment of patients with pre
Page 28 and 29: Abstract ID: 849 Author: Ng T. et a

Management of DAAs Failure

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