Treatment of HCV in Patients who Failed First-Generation PI Therapy: a Review of Current Literature

Paul Y. Kwo, Maaz B. Badshah

Research output: Contribution to journalReview article


The addition of the first direct-acting antiviral agents, the NS3 protease inhibitors boceprevir or telaprevir, to peg interferon and ribavirin was a major advance in the treatment of genotype 1 hepatitis C individuals with sustained virological response (SVR) rates of 63–75 %. Those who did not achieve SVR had high rates of resistance-associated variants against NS3 protease domain. Retreatment options for those who have failed first-generation protease inhibitors generally are guided by retreatment with direct-acting antiviral agents from other classes. Phase 2 and phase 3 data have demonstrated that retreatment with 12–24 weeks of a NS5B inhibitor (sofosbuvir) in combination with a NS5a inhibitor (daclatasvir or ledipasvir) with or without ribavirin can achieve SVR at high rates comparable to treatment-naive individuals.

Original languageEnglish (US)
Article number40
JournalCurrent gastroenterology reports
Issue number10
StatePublished - Oct 10 2015



  • Direct-acting antiviral agents
  • Hepatitis C
  • Protease inhibitors
  • Resistance

ASJC Scopus subject areas

  • Gastroenterology

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