A proof-of-concept study in HCV-infected Huh7.5 cells for shortening the duration of DAA-based triple treatment regimens - 16/06/19
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Highlights |
• | HCV is persistently present below detectable levels in HCV-infected hepatocytes for a long time after DAA treatment. |
• | Shortening therapy duration is associated with an increased risk of virologic relapse. |
• | Virologic relapse or breakthrough may be avoided by treatment with a combination of more highly effective DAAs. |
• | Virologic relapse may not occur even with intermittent treatment with a higher efficient fixed-dose of DAAs. |
Abstract |
With the development of more effective direct-acting antivirals (DAAs), dual- or triple-therapy regimens represent the major strategy used to cure chronic hepatitis C virus (HCV) infection. Thus, shorter treatment duration regimens with low burden, few adverse effects and good patient adherence are urgently needed. This study theoretically demonstrates a proof-of-concept approach for shortening therapy duration by examining HCV-infected Huh7.5 cells after treatment with a high or low fixed dose of three DAAs (simeprevir + daclatasvir + sofosbuvir) for 6–15 days. The results demonstrated that HCV-infected Huh7.5 cells achieved an ultrarapid virologic response with undetectable HCV RNA and protein and were cured after treatment with the triple-therapy regimen for 15 days. When the treatment duration was shortened, virologic relapse might occur after treatment with a low fixed dose of the three DAAs for 9 days and did occur after treatment with a low fixed dose for 6 days, although HCV was below detectable levels at the end of treatment. However, virologic relapse could be avoided with treatment of a high fixed dose of the three DAAs for 9 or 6 days. Although a virologic breakthrough occurred after an intermittent treatment regimen at the low fixed dose, the high fixed dose cured HCV-positive Huh7.5 cells with intermittent treatment. In conclusion, HCV is persistently present below detectable levels in HCV-infected Huh7.5 cells for a long time after treatment, and a shortened therapy duration is associated with an increased risk of virologic relapse, but virologic relapse or breakthrough might be avoided by treatment with a combination of more highly effective DAAs.
Le texte complet de cet article est disponible en PDF.Abbreviation : CC50, DAAs, EC50, EC90, HCV, MOI, NS, qRT-PCR, SVR, UVR, WB
Keywords : Hepatitis C virus, HCV-positive hepatocytes, DAA treatment regimens, Shorter therapy duration, Virologic relapse
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Vol 116
Article 108976- août 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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