Resistance Mutations A30K and Y93N Associated with Treatment Failure with Sofosbuvir and Daclatasvir for Hepatitis C Virus Infection Non-Responder Patients: Case Reports
Vanessa D. Costa,
Patricia Pellegrini,
Vivian Rotman,
Ana Maria Pittella,
Estevão P. Nunes,
Barbara V. Lago,
Elisabeth Lampe,
Francisco C. A. Mello
Affiliations
Vanessa D. Costa
Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Avenida Brasil, 4365–Manguinhos, 21040-900 Rio de Janeiro, RJ, Brazil
Patricia Pellegrini
Serviço de Hepatologia, Universidade Federal do Rio de Janeiro, Rua Professor Paulo Rodolpho Rocco, 255, Cidade Universitária, 21044-020 Rio de Janeiro, RJ, Brazil
Vivian Rotman
Serviço de Hepatologia, Universidade Federal do Rio de Janeiro, Rua Professor Paulo Rodolpho Rocco, 255, Cidade Universitária, 21044-020 Rio de Janeiro, RJ, Brazil
Ana Maria Pittella
Hospital Quinta D’Or. Rua Almirante Baltazar, 435, São Cristóvão, 20941-150 Rio de Janeiro, RJ, Brazil
Estevão P. Nunes
Instituto Nacional de Infectologia Evandro Chagas, INI/FIOCRUZ, Avenida Brasil, 4365-Manguinhos, 21040-360 Rio de Janeiro, RJ, Brazil
Barbara V. Lago
Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Avenida Brasil, 4365–Manguinhos, 21040-900 Rio de Janeiro, RJ, Brazil
Elisabeth Lampe
Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Avenida Brasil, 4365–Manguinhos, 21040-900 Rio de Janeiro, RJ, Brazil
Francisco C. A. Mello
Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Avenida Brasil, 4365–Manguinhos, 21040-900 Rio de Janeiro, RJ, Brazil
In Brazil, hepatitis C treatment has been evolving significantly with the licensing of direct-acting antivirals (DAAs). However, viral determinants (amino acid substitutions in hepatitis C virus (HCV) genome and infective genotype) associated with host factors (hepatic condition and prior HCV therapy) might limit the achievement of sustained virologic response (SVR). Here, we described two case reports in which the occurrence of HCV NS5A mutations A30K (subtype 3a) and Y93N (subtype 1a) might have influenced daclatasvir (DCV)/sofosbuvir (SOF) combined therapy non-response. Despite high response rates for DAA combined therapies in Brazil, these case reports stated the importance of an investigation about how to manage a DAA treatment failure since a combination of factors, especially the occurrence of resistance substitutions, could impact a rescue therapy with new available antivirals in clinical routine.
