studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 763A
The following authors have nothing to disclose: Sushrut Trakroo, Sirish Sanaka,
Hawah Musa, Mohammed Eyad Yaseen Alsabbagh, Mythili Ghanta, Swati Rao,
Lee Peng, Antonio Di Carlo, Kamran Qureshi
1123
Retreatment with sofosbuvir and simeprevir of patients
who previously failed on an HCV NS5A inhibitor–containing
regimen
Christophe Hezode 1,2 , Stephane Chevaliez 3,2 , Giovanna
Scoazec 1 , Alexandre Soulier 3,2 , Anne Varaut 1 , Magali Bouvier-Alias
3,2 , Isaac Ruiz 3,2 , Ariane Mallat 1,2 , Cyrille Feray 1,2 ,
Jean-Michel Pawlotsky 3,2 ; 1 Hepatologie, Hospital Henri Mondor,
Creteil, France; 2 INSERM U955, Creteil, France; 3 Virology, Henri
Mondor Hospital, Creteil, France
Background: Failure to achieve SVR with IFN-free regimens
based on HCV DAAs is associated with the selection of resistant
HCV variants. In contrast to variants resistant to PIs that
are progressively overgrown by wild-type virus after treatment
failure, NS5A RAVs persist for years as the dominant species
in the majority of patients. In spite of the lack of data, recent
guidelines recommended that patients exposed to NS5A inhibitors
be retreated with a combination of SOF and SMV to avoid
cross-resistance with NS5A inhibitors. Materials & Methods: 16
patients (mean age: 54 yrs) infected with GT 1 (1a: n=11; 1b:
n=3) or 4 (n=2) with compensated disease and advanced liver
fibrosis (fibroscan: 9.6-70 kPa; cirrhosis n=9) who failed to
achieve SVR after receiving DCV/PegIFN/RBV (n=13) DCV/
ASV/PegIFN/RBV (n=3), were included. They were retreated
for 12 weeks with SOF/SMV, without RBV. HCV RNA levels
were measured with Abbott RealTime Assay (LLOQ/LOD: 12
IU/mL). HCV resistance was assessed at retreatment baseline
by means of population sequencing home made methods targeting
the NS3 and NS5A coding regions. Results: The median
baseline HCV RNA level at retreatment was 1.38 x 10 6 IU/mL
(>800,000 IU/mL: n=14). No patient discontinued treatment
due to an adverse event or for virologic failure. Among the 16
patients, 10 had a rapid virologic response (HCV RNA