1 Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany.
2 Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany.
3 Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland.
4 I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany.
5 Center for HIV and Hepatogastroenterology, Düsseldorf, Germany.
6 Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany.
7 Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany.
8 Medical Department I, University Hospital Schleswig-Holstein, Kiel, Germany.
9 Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany.
10 Institute for Interdisciplinary Medicine IFI, Hamburg, Germany.
11 Department of Internal Medicine I, Ulm University, Ulm, Germany.
12 Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
13 Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland.
14 Department of Internal Medicine, Medical University of Graz, Graz, Austria.
15 Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany.
16 Department of Internal Medicine I, University of Tübingen, Tübingen, Germany.
17 Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany. Electronic address: firstname.lastname@example.org.
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.