All-oral daclatasvir plus asunaprevir for hepatitis C virus genotype 1b: a multinational, phase 3, multicohort study

Can the Abbott RealTime hepatitis C virus assay be used to predict therapeutic outcomes in hepatitis C virus-infected patients undergoing triple therapy?

“…However, some patients are difficult to treat because of an increase in drug resistance (30,31), and in many developing countries where HCV is endemic, IFN-based therapy will remain the first choice because of the high cost of DAAs (32). In addition, since there are CHC patients that experience relapse or viral breakthrough after completion of oral therapy with DAAs (33,34), IFN still plays an important role in the treatment of CHC patients. IFN's broad antiviral activity could help clear resistant strains and improve the chance of successful re-treatment with DAA therapy; therefore, we should consider using sensitive detection methods such as ART in order to accurately monitor IFN-based therapeutic outcomes.…”

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

“…RAVs may be associated with inferior treatment efficacy, such as the resistance of HCV GT1a with Q80K mutation to simeprevir, a nonstructural protein 3/4A (NS3/4) protease inhibitor, plus peginterferon/ribavirin [181], and HCV GT-1b with NS5A-L31F/ I/M/V and/or NS5A-Y93H mutation resistance to the daclatasvir/asunaprevir all-oral regimen [182]. Excluding patients with preexisting RAVs could enhance treatment efficacy [183].…”

Hepatitis C virus: Virology, diagnosis and treatment

“…In early 2014, several reports regarding novel DAAs have been published: (1) Combined simeprevir and sofosbuvir was efficacious and well tolerated for patients with HCV genotype 1 [92] ; (2) Combined daclatasvir (NS5A replication complex inhibitor) and asunaprevir (NS3/4A protease inhibitor) could be used as an all-oral, PR-free treatment option for patients with HCV subtype 1b infection, including those with cirrhosis [93] ; (3) In combinations with other oral DAAs, dasabuvir (a nonnucleoside inhibitor of NS5B) results in very high rates of SVR (about 95%) in patients with HCV genotype 1 infection with a good tolerability and safety [94] ; (4) The sustained response rate of ABT-450, a potent inhibitor of NS3/4A protease, plus other direct antiviral drugs reaches 90%-95% in both naïve and treatmentexperienced genotype 1 patients, and tolerability is good [95] ; (5) Sofosbuvir was also effective in patients coinfected with HCV and HIV [96] ; (6) Sofosbuvir plus PR achieved high SVR rates in patients with HCV genotype 1 infection, and also appeared effective in patients with HCV genotype 4, 5 or 6 infection. Oral sofosbuvir was generally well tolerated in CHC patients [97] ; (7) In combinations with other oral DAAs, ombitasvir (an inhibitor of the HCV NS5A) achieves very high rates of SVR (about 95%) in patients with HCV genotype 1 infection with a good tolerability [98] ; and (8) Combination of daclatasvir and asunaprevir results in a very high rate of viral eradication in both treatment-naïve and treatment-experienced patients, with a SVR rate of 80%-90% [99] .…”