• Internal medicine · Sep 2019

    Case Reports

    Role of NS5A-L31/Y93 Double Wild-type in Failure of Glecaprevir/Pibrentasvir Double Therapy in Two Patients with a History of Direct-acting Antiviral Agent Failure: An Ultra-deep Sequencing Analysis.

    • Tomoya Sano, Norio Akuta, Fumitaka Suzuki, Kayoko Kasuya, Shunichiro Fujiyama, Yusuke Kawamura, Hitomi Sezaki, Tetsuya Hosaka, Satoshi Saitoh, Masahiro Kobayashi, Yoshiyuki Suzuki, Mariko Kobayashi, Yasuji Arase, Kenji Ikeda, and Hiromitsu Kumada.
    • Department of Hepatology, Toranomon Hospital, Japan.
    • Intern. Med. 2019 Sep 15; 58 (18): 265726622657-2662.

    AbstractWe experienced two cases of hepatitis C virus (HCV) eradication failure in patients with a history of non-responsiveness to previous treatments with direct-acting antiviral agents (DAAs) who were subsequently treated with the combination of glecaprevir and pibrentasvir (GLE/PIB). Direct sequencing at commencement of GLE/PIB therapy showed non-structural protein (NS) 5A-P32 deletion in the first patient and NS5A-R30E/Q54H/A92K in the second patient (both genotype 1b). The common point was that L31/Y93 was double wild-type, and the IL28B polymorphism was non-TT type. Even when L31/Y93 is double wild-type, other NS5A mutations may affect the DAA re-treatment outcome. We analyzed the transition of amino acid mutations at NS5A by ultra-deep sequencing.

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