1,516 patients with chronic HCV genotype 1b infection, who were treated with all-oral combinations of direct-acting antivirals (DAAs), were evaluated NS5A resistance-associated variants. 6 of 110 patients (5.45%), who could not achieve sustained virological response after Asunaprevir plus Daclatasvir for 24 weeks, were detected NS5A-P32 deletion. 4 of 6 patients with P32 deletion received retreatment of DAAs, and could not achieve sustained virological response. All of 6 patients with P32 deletion, were with three treatment-resistant host-factors of IL28B rs8099917 TG, FIB-4 index ≥3.25, and non-response for prior interferon-related therapy. Further understanding of the complex interaction between virus- and host-related factors might facilitate the development of more effective therapeutic regimens for HCV patients with P32 deletion.
