Although direct acting antivirals (DAAs) have revolutionized the treatment of hepatitis C virus (HCV), a small fraction of patients still experience treatment failure. In an editorial in a special issue of the journal Viruses, Che Colpitts, PhD, and Thomas Baumert, MD, of the Institute of Research of Viral Maladies in Strasbourg, France, describe why the research included is important to the future of treating HCV.
“In the USA, chronic hepatitis C infection, the most common cause of liver-related death and liver transplantation, recently surpassed human immunodeficiency virus (HIV) infection as a cause of mortality,” say the authors in the introduction. Patients who do not reach sustained virological response (SVR) are more likely to have a resistant variant. The class of DAA, the genotype of HCV, and the patient group are all factors in the mechanisms of resistance.
The authors point out that, “given that the outcome of DAA-based therapies may be affected by the selection of resistant variants, virological tools to monitor drug resistance both in the drug development stage as well as in the clinic are of critical importance.” There are some diagnostic tools which monitor HCV-resistance, and resistance does not necessarily mean treatment cannot be successful.