Clinical and Medical Case Reports

Relapse with NS5A Cross - Resistant HCV Variant after Cure Treatment with Ledipasvir/Sofosbuvir in a Turkish Patient with Chronic Hepatitis C: A Case Report

Abstract

Sarigul F*, Sayan M, User U and Oztoprak N

In chronic hepatitis C (CHC) treatment, direct acting antiviral agents (DAAs) are strongly effective and well tolerated, whereas with new DAAs, virological failures are common. At present, no data exists for RAVs of DAAs in Turkey. Genotypic resistance testing was performed by viral population sequencing of the NS3, NS5A and NS5B regions using plasma samples. The patient treatment-experienced with pegylated interferon- ribavirin was treated with 12-week course of ledipasvir/sofosbuvir and ribavirin. Three months after completing the treatment, virological relapse was occurred. Molecular analysis demonstrated that Y93H as a cross - resistant mutation for NS5A region related resistance mutation was determined. In addition, S282G and C316S were determined as amino acid substitution for NS5B region. This case shows that resistance testing for RAVs after virological failure with DAAs must be performed for the new DAA regime for CHC patients