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Hepatitis c late relapse in patients with directly acting antiviral- related sustained virological response at week 12.

Liver Int. 2018 Dec 16;:

Authors: Pisaturo M, Minichini C, Starace M, Caroprese M, Macera M, Brancaccio G, De Pascalis S, Santonicola A, Lanza AG, Zampino R, Cotticelli G, Sagnelli E, Gaeta GB, Coppola N

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: 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 2 of the 7 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 5 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. This article is protected by copyright. All rights reserved.

PMID: 30554459 [PubMed – as supplied by publisher]

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