학술논문

Discussion on critical points for a tailored therapy to cure hepatitis C virus infection
Document Type
Article
Source
Clinical and Molecular Hepatology(대한간학회지) / Clinical and Molecular Hepatology (CMH). Mar 31, 2019 25(1):30
Subject
Direct-acting antivirals
Resistance-associated substitutions
Genetic variation
Deep sequencing
Language
Korean
ISSN
2287-2728
Abstract
Hepatitis C virus (HCV) infects around 71 million people worldwide and in 2018 it is still a major health problem. Since 2011, anti-HCV therapy with availability of direct-acting antiviral drugs has revolutionized the clinical response and paved the way to eradication strategies. However, despite the high rate of sustained virological response, treatment failure may occur in a limited percentage of patients, possibly due to resistance-associated substitutions (RASs), either emergent or pre-existent even in minority viral populations. Clearly this problem may impair success of eradication strategies. With this background, several questions marks still exist around HCV treatment, including whether pan-genotypic treatments with complete effectiveness in any clinical conditions really exist outside clinical trials, the actual cost-effectiveness of genotyping testing, and utility of RAS detection in viral quasispecies by next generation sequencing approach. In this review, we describe these critical points by discussing recent literature data and our research experience.