Retreatment of patients with chronic hepatitis C, subtype 3a, and cirrhosis, who previously failed a regimen containing second-generation NS5A inhibitors with sofosbuvir + glecaprevir/pibrentasvir and ribavirin for 16-24 weeks

Abstract Background: The use of direct acting antiviral agents (DAAs) in patients with chronic HCV genotype (GT) 3a infection results in sustained virologic response (SVR) rates of 93-98%, but 3-6% of patients experience virologic failure. Methods: We observed 11 patients infected with HCV subtype 3a who failed previous treatment with DAAs, with liver cirrhosis. All patients previously failed with sofosbuvir+velpatasvir+ribavirin for 24 weeks. Patients received retreatment with sofosbuvir, glecaprevir/pibrentasvir and ribavirin for 16-24 weeks. We compared SVR₁₂ rates depending on the presence of NS5A mutation (L31M, A30K, Y93H or double mutations). Results: Observed SVR₁₂ rate was: 100% (11/11 patients) overall. Conclusion:s Retreatment with SOF+GLE/PIB+RBV for 16-24 weeks was highly effective and safe in patients with chronic HCV GT3a infection, including those with liver cirrhosis, who previously failed DAA containing second-generation NS5A inhibitors. Presence of NS5A RASs L31M, A30K, Y93H or double mutations at the baseline did not impact SVR₁₂ rates.