The goal of these CME/CE activities are to help clinicians diagnose, treat, and manage patients with Hepatitis C using this interactive, dynamic, and continually updated resource at the point of care, via web or mobile device.
Contributing Editor: Robert G. Gish, MD
INTRODUCTION: The emergence of viral resistance is an issue with current direct-acting antiviral (DAA) regimens, which work by directly targeting the hepatitis C virus (HCV) viral genome, whereas it was not an issue with peginterferon-based therapy, which works primarily by modulating the immune system. Any naturally occurring baseline mutation in the genome that confers resistance to a given DAA regimen has the potential to compromise the patient outcome of sustained virologic response (SVR) or cure. To offer patients the best access to the high cure rates associated with current DAA regimens, clinicians need to understand how resistance develops, how resistance has an impact on the potential for SVR, and in which regimens and patient groups resistance becomes clinically meaningful. In this chapter we will explain the basics of viral resistance, review data from key clinical trials demonstrating the impact of resistant mutations on SVR, and identify the indications for resistance testing in clinical practice.
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