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dc.contributor.authorPérez, Ana Belénes_ES
dc.contributor.authorChueca, Nataliaes_ES
dc.contributor.authorGarcía-Deltoro, Migueles_ES
dc.contributor.authorMartínez-Sapiñez, Ana Maríaes_ES
dc.contributor.authorLara-Pérez, María Magdalenaes_ES
dc.contributor.authorGarcía-Bujalance, Silviaes_ES
dc.contributor.authorAldámiz-Echevarría, Teresaes_ES
dc.contributor.authorVera-Méndez, Francisco Jesúses_ES
dc.contributor.authorPineda, Juan A.es_ES
dc.contributor.authorCasado, Martaes_ES
dc.contributor.authorPascasio, Juan Manueles_ES
dc.contributor.authorSalmerón, Javieres_ES
dc.contributor.authorAlados, Juan Carloses_ES
dc.contributor.authorPoyato, Antonioes_ES
dc.contributor.authorTéllez, Franciscoes_ES
dc.contributor.authorRivero-Juárez, Antonioes_ES
dc.contributor.authorMerino, Doloreses_ES
dc.contributor.authorVivancos-Gallego, María Jesúses_ES
dc.contributor.authorRosales-Zábal, José Migueles_ES
dc.contributor.authorGarcía, Federicoes_ES
dc.date.accessioned2020-02-20T13:57:24Z-
dc.date.available2020-02-20T13:57:24Z-
dc.date.issued2019-11-
dc.identifier.citationJournal of Hepatology 71(5): 876-888 (2019)es_ES
dc.identifier.urihttp://hdl.handle.net/10261/201418-
dc.descriptionGEHEP-004 Study Group: María Dolores Ocete, Miguel Ángel Simón, Pilar Rincón, Sergi Reus, Alberto De la Iglesia, Isabel García-Arata, Miguel Jiménez, Fernando Jiménez, José Hernández-Quero, Carlos Galera, Mohamed Omar Balghata, Joaquín Primo, Mar Masiá, Nuria Espinosa, Marcial Delgado, Miguel Ángel von-Wichmann, Antonio Collado, Jesús Santos, Carlos Mínguez, Felícitas Díaz-Flores, Elisa Fernández, Enrique Bernal, José De Juan, José Joaquín Antón, Mónica Vélez, Antonio Aguilera, Daniel Navarro, Juan Ignacio Arenas, Clotilde Fernández, María Dolores Espinosa, María José Ríos, Roberto Alonso, Carmen Hidalgo, Rosario Hernández, María Jesús Téllez, Francisco Javier Rodríguez, Pedro Antequera, Cristina Delgado, Patricia Martín, Javier Crespo, Berta Becerril, Óscar Pérez, Antonio García-Herola, José Montero, Carolina Freyre, Concepción Grau.es_ES
dc.description.abstract[Background & Aims] Most hepatitis C virus (HCV)-infected patients failing NS5A inhibitors develop resistance-associated substitutions (RASs). Here we report the use of resistance-guided retreatment of patients who failed prior NS5A inhibitor-containing regimens in the GEHEP-004 cohort. This is the largest direct-acting antiviral (DAA)-resistance cohort study conducted in Spain. We aim to provide indications on how to use resistance information in settings where sofosbuvir/velpatasvir/voxilaprevir may not be available.es_ES
dc.description.abstract[Methods] GEHEP-004 is a prospective multicenter cohort enrolling HCV-infected patients treated with interferon (IFN)-free DAA regimens. Prior to retreatment, population-based sequencing of HCV NS3, NS5A and NS5B genes was performed. After receiving a comprehensive resistance interpretation report, the retreatment regimen was chosen and the sustained virological response (SVR) at 12 weeks after treatment completion (SVR12) was recorded.es_ES
dc.description.abstract[Results] A total of 342 patients experiencing virological failure after treatment with sofosbuvir/ledipasvir±ribavirin (54%), sofosbuvir/daclatasvir±ribavirin (23%), or paritaprevir-ritonavir/ombitasvir±dasabuvir±ribavirin (20%) were studied. After a resistance report, 186 patients were retreated. An SVR12 was achieved for 88.1% of the patients who failed after sofosbuvir/ledipasvir±ribavirin, 83.3% of the patients who failed after sofosbuvir/daclatasvir±ribavirin, 93.7% of the patients who failed after paritaprevir-ritonavir+ombitasvir±dasabuvir±ribavirin.es_ES
dc.description.abstract[Conclusions] In our study, we show how resistance-guided retreatment in conjunction with an interpreted report allows patients to achieve SVR rates close to 90%. We hypothesize that SVR rates may even be improved if resistance data are discussed between experienced virologists and treating clinicians. We believe that our data may be relevant for countries where the access to new DAA combination regimens is limited.es_ES
dc.description.abstract[Lay summary] Hepatitis C infection can be cured with currently available antiviral agents. Only a small proportion of patients experience treatment failure, however, in absolute numbers, a high number of patients may require retreatment. Highly effective combinations of antivirals are also available for retreatment. However, these antivirals might not be available in resource-limited settings. Herein, we show how, by analyzing the cause of resistance, retreatment efficacy with old drugs can get very close to the efficacy of new drug combinations.es_ES
dc.description.sponsorshipThis work was supported in part by grants from Fondo de Investigación Sanitaria (www.isciii.es) (PI15/00713), Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional-FEDER (www.redes/redes/inicio) (RD16/0025/0040), Fundación Progreso y Salud, Junta de Andalucia (http://www.juntadeandalucia.es/fundacionprogresoysalud/es) (PI-0411-2014), and GEHEP-SEIMC (GEHEP-004).es_ES
dc.language.isoenges_ES
dc.publisherElsevieres_ES
dc.rightsclosedAccesses_ES
dc.subjectHCVes_ES
dc.subjectRASses_ES
dc.subjectTreatment failurees_ES
dc.subjectResistance testinges_ES
dc.subjectResistance-associated substitutiones_ES
dc.subjectDirect-acting antiviralses_ES
dc.subjectRibavirines_ES
dc.titleHigh efficacy of resistance-guided retreatment of HCV patients failing NS5A inhibitors in the real worldes_ES
dc.typeartículoes_ES
dc.identifier.doi10.1016/j.jhep.2019.06.022-
dc.description.peerreviewedPeer reviewedes_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.jhep.2019.06.022es_ES
dc.identifier.e-issn0168-8278-
dc.contributor.funderInstituto de Salud Carlos IIIes_ES
dc.contributor.funderEuropean Commissiones_ES
dc.contributor.funderFundación Progreso y Saludes_ES
dc.contributor.funderJunta de Andalucíaes_ES
dc.contributor.funderSociedad Española de Enfermedades Infecciosas y Microbiología Clínicaes_ES
dc.relation.csices_ES
oprm.item.hasRevisionno ko 0 false*
dc.identifier.funderhttp://dx.doi.org/10.13039/501100000780es_ES
dc.identifier.funderhttp://dx.doi.org/10.13039/501100004587es_ES
dc.identifier.funderhttp://dx.doi.org/10.13039/501100011011es_ES
dc.type.coarhttp://purl.org/coar/resource_type/c_6501es_ES
item.openairetypeartículo-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.grantfulltextnone-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
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