Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
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 SanoNorio AkutaFumitaka SuzukiKayoko KasuyaShunichiro FujiyamaYusuke KawamuraHitomi SezakiTetsuya HosakaSatoshi SaitohMasahiro KobayashiYoshiyuki SuzukiMariko KobayashiYasuji AraseKenji IkedaHiromitsu Kumada
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JOURNALS OPEN ACCESS Advance online publication

Article ID: 2604-18


We experienced two cases of 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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© 2019 by The Japanese Society of Internal Medicine
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