Ken Sato
Gunma University Graduate School of Medicine, Japan
Title: The next stage strategy for Direct-acting antiviral failure in patients with chronic hepatitis C
Biography
Biography: Ken Sato
Abstract
Direct-acting antiviral (DAA)-based therapy has become 1st choice for patients with chronic hepatitis C. According to the guidelines or areas, DAA-based regimens that are approved varies. In Japan, sofosbuvir/ledipasvir (SOF/LDV), elbasvir/grazoprevir (EBR/GZR) or glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/ribavirin (SOF/RBV) or GLE/PIB combination therapies are the 1st choice therapeutic options for patients with hepatitis C virus (HCV) genotype 1 and 2 according to the Japan Society of Hepatology (JSH) guideline for the management of HCV infection, respectively. The rate of sustained virological response is more than 90-95% in most of the regimens. Unfortunately, a small but certain portion of patients have to experience DAA failure. This is the unmet needs to be addressed for hepatologists. I will present the effects of the combination therapy with daclatasvir/asunaprevir/beclabuvir (DCV/ASV/BCV) and SOF/RBV for patients with treatment failure of DCV/ASV and ombitasvir/paritaprevir/ritonavir plus ribavirin (OBV/PTV/r+RBV) in patients with HCV genotype 1 and 2, respectively. The efficacy of DCV/ASV/BCV and SOF/RBV for treatment-naïve patients with HCV genotype 1 and 2 are reportedly 96% and 98%, respectively. However, there is no report showing the efficacy of each regimen for the corresponding previous DAA regimen failure to date. In Japan, the combination therapy with GLE/PIB has recently approved and are available. This therapy is a pan-genotype DAA regimen and is reportedly effective for patients with treatment failure of the combination therapy with DCV/ASV and SOF/RBV. I will also present the effects of the combination therapy with GLE/PIB for patients with treatment failure of DCV/ASV/BCV combination therapy, which have not been reported yet. The next stage strategy for DAA failure will be discussed. To elucidate HCV infection is also key to prevent new infection to HCV by decreasing HCV infected peoples.