{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:42Z","timestamp":1756339602644,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,2,4]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>Some individuals do not achieve a cure of their hepatitis C virus (HCV) infection due to non-adherence or resistance associated substitutions. Salvage options that are optimised for resistance profiles are essential. We report a 56-year-old Caucasian man with fatigue, depression and confusion in the setting of untreated HCV genotype 3a infection. He received ruzasvir and uprifosbuvir for 12 weeks within a clinical trial. The patient relapsed 4\u2009weeks after the end of treatment and at this time resistance testing showed multiple resistances including a NS5A Y93H mutation. Given that this mutation confers resistance to first line salvage options, sofosbuvir and glecaprevir\/pibrentasvir was used for 12 weeks and the patient was cured of HCV infection 12 weeks after the end of treatment. This shows that sofosbuvir and glecaprevir\/pibrentasvir is a viable, effective option for second line\/salvage therapy of HCV infection in the setting of resistance to NS5A inhibitors with the Y93H mutation.<\/jats:p>","DOI":"10.1136\/bcr-2019-233098","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T04:15:20Z","timestamp":1581480920000},"page":"e233098","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Glecaprevir\/pibrentasvir+sofosbuvir: an optimal retreatment strategy in the setting of HCV NS5A resistance"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4321-4469","authenticated-orcid":false,"given":"Arshia","family":"Alimohammadi","sequence":"first","affiliation":[{"name":"Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada"},{"name":"Faculty of Medicine, Univertisy of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Conway","sequence":"additional","affiliation":[{"name":"Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"2025082712412016000_13.2.e233098.1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jvh.12763","article-title":"Estimating HCV disease burden-volume 4 (editorial)","volume":"24 Suppl 2","author":"Dore","year":"2017","journal-title":"J Viral Hepat"},{"key":"2025082712412016000_13.2.e233098.2","doi-asserted-by":"crossref","first-page":"S538","DOI":"10.1016\/S0168-8278(17)31482-4","article-title":"Comprehensive 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C","volume":"12","year":"2018","journal-title":"Clin Liver Dis"},{"key":"2025082712412016000_13.2.e233098.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613512"},{"key":"2025082712412016000_13.2.e233098.11","first-page":"103","article-title":"Understanding hepatitis C virus drug resistance: clinical implications for current and future regimens","volume":"25","author":"Wyles","year":"2017","journal-title":"Top Antivir Med"},{"key":"2025082712412016000_13.2.e233098.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1512612"},{"key":"2025082712412016000_13.2.e233098.13","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s12328-019-00997-5","article-title":"Successful treatment of chronic hepatitis C virus infection with crushed glecaprevir\/pibrentasvir administered via a percutaneous endoscopic gastrostomy tube: case report and review of the literature","volume":"12","author":"Tanaka","year":"2019","journal-title":"Clin J 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