Management of DAAs Failure
If you have failure of plan A in treating a patient with chronic hepatitis C. What's your plan B
If you have failure of plan A in treating a patient with chronic hepatitis C. What's your plan B
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Summary<br />
• Treatment-emergent RAV(S) seen in treatment failure and in all DAA classes and<br />
rarely with SOF<br />
• NS3 RAVs have low replication efficacy and disappear over 9-18 mos<br />
• If considering SMV + SOF: In treatment-naive and treatment-experienced pts<br />
with both genotype 1a HCV infection and compensated cirrhosis, ensure no<br />
Q80K<br />
• NS5A treatment-emergent RAVs persistent and a clinical challenge<br />
• If failure with any NS5A inhibitors , and treatment is urgent, test for NS3 and<br />
NS5A RAVs<br />
• Use SMV + SOF + RBV if NS5A but no NS3 RAVs<br />
• Use LDV/SOF orDacla + RBV if no NS5A RAVs<br />
• Treat in clinical trial if both NS5A and NS3 RAVs present
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