Hepatitis C late relapse in patients with directly acting antiviral‐related sustained virological response at week 12. (4th January 2019)

• Record Type: Journal Article
• Authors: Pisaturo, Mariantonietta; Minichini, Carmine; Starace, Mario; Caroprese, Mara; Macera, Margherita; Brancaccio, Giuseppina; De Pascalis, Stefania; Santonicola, Antonella; Galeota Lanza, Alfonso; Zampino, Rosa; Cotticelli, Gaetano; Sagnelli, Evangelista; Gaeta, Giovanni Battista; Coppola, Nicola
• Is Part Of: Liver international. Volume 39:Number 5(2019)
• Page Start: 844
• Page End: 853
• Publication Date: 2019-01-04
• Subjects: DAA -- HCV infection -- non‐response -- relapse; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.14025
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Aim: The aim of the present study was to identify, among the patients with failure to DAA regimen, those with a late relapse (after the achievement of a sustained virological response at week 12) and to characterize the clinical, epidemiological and virological features of these patients. Material and methods: A total of 129 HCV patients with non‐response to an IFN‐free regimen were enrolled. Sanger sequencing of NS3, NS5A and NS5B was performed at failure by home‐made protocols. Results: Of the 129 patients enrolled, 8 (6.2%) experienced a breakthrough, 15 (11.7%) non‐response, 99 (76.7%) a relapse by week 12 after the end of DAA therapy, and 7 (5.4%) a late relapse (after week 12; median 24 weeks, range 24‐72). For two of the seven patients with a late relapse, a serum sample collected before the start of the DAA regimen was available; phylogenetic analysis showed no change in sequences of NS3, NS5A and NS5B regions, suggesting a reactivation of the initial HCV strain; for the remaining five patients, no serum collected before the DAA regimen was available, and thus, a re‐infection cannot be excluded. Conclusions: Although a late relapse is infrequent, the study suggests a post‐treatment follow‐up of 72 weeks.