Perez, Ana BelenChueca, NataliaMacias, JuanPineda, Juan AntonioSalmeron, JavierRivero-Juarez, AntonioHidalgo-Tenorio, CarmenEspinosa, Maria DoloresTellez, FranciscoVon-Wichmann, Miguel AngelOmar, MohamedSantos, JesusHernandez-Quero, JoseAnton, Jose JoaquinCollado, AntonioLozano, Ana BelenGarcia-Deltoro, MiguelCasado, MartaPascasio, Juan ManuelSelfa, AidaRosales, Jose MiguelDe la Iglesia, AlbertoArenas, Juan IgnacioGarcia-Bujalance, SilviaRios, Maria JoseBernal, EnriqueMartinez, OnofreGarcia-Herola, AntonioVelez, MonicaRincon, PilarGarcia, Federico2023-01-252023-01-252019-08-01Pérez AB, Chueca N, Macías J, Pineda JA, Salmerón J, Rivero-Juárez A, et al. Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort. PLoS One. 2019 Aug 30;14(8):e0221231http://hdl.handle.net/10668/14460Treatment guidelines differ in their recommendation to determine baseline resistance associated substitutions (RAS) before starting a first-line treatment with direct-acting antivirals (DAAs). Here we analyze the efficacy of DAA treatment with baseline RAS information. We conducted a prospective study involving 23 centers collaborating in the GEHEP-004 DAA resistance cohort. Baseline NS5A and NS3 RASs were studied by Sanger sequencing. After issuing a comprehensive resistance report, the treating physician decided the therapy, duration and ribavirin use. Sustained virological response (SVR12) data are available in 275 patients. Baseline NS5A RAS prevalence was between 4.3% and 26.8% according to genotype, and NS3 RASs prevalence (GT1a) was 6.3%. Overall, SVR12 was 97.8%. Amongst HCV-GT1a patients, 75.0% had >800,000 IU/ml and most of those that started grazoprevir/elbasvir were treated for 12 weeks. In genotype 3, NS5A Y93H was detected in 9 patients. 42.8% of the HCV-GT3 patients that started sofosbuvir/velpatasvir included ribavirin, although only 14.7% carried Y93H. The efficacy of baseline resistance-guided treatment in our cohort has been high across the most prevalent HCV genotypes in Spain. The duration of the grazoprevir/elbasvir treatment adhered mostly to AASLD/IDSA recommendations. In cirrhotic patients infected with GT-3 there has been a high use of ribavirin.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Área de Gestión Sanitaria Sur de GranadaÁrea de Gestión Sanitaria Sur de SevillaAmidesAntiviral agentsBenzofuransCarbamatesCyclopropanesDrug resistance, viralFemaleGenotypeHepacivirusHepatitis C, chronicHumansImidazolesMaleMiddle agedMutationQuinoxalinesRibavirinSofosbuvirSpainSulfonamidesSustained virologic responseViral nonstructural proteinsresearch article31469856open accessEspañaGenotipoHepatitis C crónicaMutaciónProteínas no estructurales viralesRespuesta virológica sostenidaRibavirinaSulfonamidas10.1371/journal.pone.02212311932-6203PMC6716636https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0221231&type=printablehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716636/pdf