Study on the clinical characteristics and genotype of direct-acting antiviral therapy failure in treatment of hepatitis C
Objective To explore the clinical and genotypic characteristics of patients with chronic hepatitis C(CHC)who experienced treatment failure with direct-acting antiviral drugs(DAAs).Methods Between September 2021 and December 2022,28 patients who failed in DAA treatment in our hospital were selected as the observation group,and 100 patients who succeeded in DAA treatment in the same period were selected as the control group.Liver function was detected by enzyme method,hepatitis C virus(HCV)genotype was detected by PCR-reverse hybridization method,and drug resistance-associated substitution mutation(RAS)fragment was detected by Sanger sequencing method.The clinical characteristics and genotype characteristics of patients in DAA observation group were analyzed.Results There were 23 cases(82.1％)and 34 cases(34.0％)with HCV-RNA load＞105 IU/ml in the observation group and the control group respectively,and the difference was statistically significant(x2=20.526,P=0.001).In DAA treatment observation group,the TBIL and DBIL of male patients were 14.61(10.98-20.78)μmol/L and 4.94(3.08-7.48)μmol/L,respectively,which were significantly higher than those of female patients[6.65(4.90-8.40)μmol/L and 2.50(1.78-3.07)μmol/L,Z=-2.018,-2.456,P=0.010 and 0.010,respectively].Three HCV genotypes were detected in the included patients,namely 1b,2a and 3b,and 26 of them were undetected.HCV 1b,2a and 3b genotypes in the observation group were 11(39.3％),6(21.4％)and 5(17.8％),of while in the control group were 56(56.0％),15(15.0％)and 9(9.0％),respectively.NS5A and NS5B2 gene fragments were detected in DAA treatment observation group,but the incidence of RAS was different.Conclusion Patients who experience DAA treatment failure are influenced by factors such as patient gender,viral load,genotypic variations,and types of RAS.
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