Effect of Baseline Resistance-Associated Substitutions on Thalassemia Patients with Chronic HCV Infection: A Two-Year Follow-Up

Fahimeh Safarnezhad Tameshkel, Mohammad Hadi Karbalaie Niya, Mahmoodreza khoonsari, Hossein Ajdarkosh, Amir Hossein Faraji, Mehdi Nikkhah, Nima Motamed, Azita Azarkeivan, Ali Gholami, Masood Reza Sohrabi, Hossein Keyvani, Farhad Zamani



Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection showed the presence of resistant-associated substitutions (RASs). The aim of the present study was to carry out a follow-up of patients with baseline RASs to report the impact of RASs on DAA therapy outcome.


 In a cohort study, we analyzed NS5A and NS5B RASs among nine thalassemia cases by baseline RASs. In a 2-year follow-up, we analyzed viral markers and biochemical and hematological parameters of the participants and their sustained virologic response (SVR). Statistical analyses were performed using SPSS software version 22.


RASs for HCV subtype 1a included M28V, L31M, and H58P.  For subtype 1b: L28M, R30Q, S24F, and C316N. And for subtype 3a: C316S, and S24F. In patients with cirrhosis (n=5), ALT (p=0.001) and AST (p =0.007) levels were significantly reduced after treatment, and creatinine level slightly increased (p =0.025). However, no significant data was observed in non-cirrhotic patients following the treatment.


The present study did not show any adverse effects of DAA therapy among patients with thalassemia suffering from chronic HCV infection with baseline RASs. Furthermore, reduction in ferritin and liver stiffness levels after DAA therapy could show the efficacy of DAA in such patients.


Direct acting antivirals (DAAs); Resistant associated substitutions (RASs); Chronic HCV infection

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