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Letter to the Editor| Volume 68, ISSUE 4, P864-866, April 2018

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Reply to: “Reply to: ‘Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries’”

Published:January 12, 2018DOI:https://doi.org/10.1016/j.jhep.2017.11.044
      We thank Zeuzem et al. for their response to our recently published findings.
      • Zeuzem S.
      • Dvory-Sobol H.
      • Brainard D.M.
      Reply to: “Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries”: No effect of resistance-associated substitutions in patients with rare HCV subtypes following treatment with sofosbuvir-containing regimens.
      • da Silva Filipe A.
      • Sreenu V.
      • Hughes J.
      • Aranday-Cortes E.
      • Irving W.L.
      • Foster G.R.
      • et al.
      Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries.
      Their data provide a valuable addition to reports describing virological outcomes for patients infected with “rare” subtypes who have received sofosbuvir (SOF)-based therapy but have not been well represented in previous large-scale clinical trials. We agree with the authors that assessing treatment outcome in cohorts infected with poorly characterized or uncharacterized subtypes would ideally be determined from patients who have achieved both sustained virological response (SVR) and have had a treatment relapse. However, well-defined cohorts do not exist in most low- and middle-income countries (LMICs) where such subtypes are typically found, and consequently the necessary evidence base has been lacking.

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      References

        • Zeuzem S.
        • Dvory-Sobol H.
        • Brainard D.M.
        Reply to: “Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries”: No effect of resistance-associated substitutions in patients with rare HCV subtypes following treatment with sofosbuvir-containing regimens.
        J Hepatol. 2017; 67: 1350-1352
        • da Silva Filipe A.
        • Sreenu V.
        • Hughes J.
        • Aranday-Cortes E.
        • Irving W.L.
        • Foster G.R.
        • et al.
        Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries.
        J Hepatol. 2017; 67: 1348-1350
        • Niebel M.
        • Singer J.B.
        • Nickbakhsh S.
        • Gifford R.J.
        • Thomson E.C.
        Hepatitis C and the absence of genomic data in low-income countries: a barrier on the road to elimination?.
        Lancet Gastroenterol Hepatol. 2017; 2: 700-701