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HCV EASL Treatment Guidelines / 16-24 Weeks Retreatment / Retreatment of patients who failed after a protease inhibitor- and/or NS5A inhibitor-containing regimen
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Preliminary data suggest that retreatment can be optimised based on RAS testing.263 The RASs that have been shown to confer reduced susceptibility to the corresponding drug class in vitro and/or that have been reported to be selected by DAA-containing therapies in patients who failed to achieve SVR are summarised (Table 9).53, 264 These many RASs and a number of alternative substitutions at the same positions can be present prior to retreatment in patients previously exposed to DAAs. Based on the current state of knowledge, no specific algorithms to guide retreatment decisions can be derived from these observations. Thus, retreatment must be guided either by the knowledge of which drugs were administered in previous treatment courses if no resistance test is available or, if resistance testing is performed, by probabilities of response according to the resistance profile observed and the treating team’s experience.


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