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Critical Reviews™ in Eukaryotic Gene Expression
IF: 2.156 5-Year IF: 2.255 SJR: 0.649 SNIP: 0.599 CiteScore™: 3

ISSN Print: 1045-4403
ISSN Online: 2162-6502

Critical Reviews™ in Eukaryotic Gene Expression

DOI: 10.1615/CritRevEukaryotGeneExpr.2020033704
Forthcoming Article

Drug resistance in Hepatitis C Virus: Future prospects and strategies to combat it.

Iqra Almas
University of The Punjab
Samia Afzal
University of The Punjab
Hamna Imtiaz
University of The Punjab
Mahrukh Akbar
University of The Punjab
Muhammad Daud
University of The Punjab
Anam Saghir
University of The Punjab
Iram Amin
University of The Punjab
Muhammad Shahid
University of The Punjab
Muhammad Idrees
University of The Punjab

ABSTRACT

Induction of highly pathogenic hepatitis C virus majorly causes chronic hepatitis round the world. This virus becomes easily prone to develop resistance against antiviral drugs due to two viral polymerases that do not possess the proofreading and overlapping reading frame abilities. Several reasons have been elucidated in the context to explain the building up of resistance against antiviral drug treatment. Different resistance assays are now available for HCV resistant variant detection including phenotypic and genotypic assays, and next generation sequencing. But these assays are of a little value at baseline because they are not influential enough for making therapeutic decisions in HCV patients. Moreover, HCV monitoring is now an essential part of clinical practice. Special patients such as those with thalassemia, renal transplanted due to renal failure and the patients undergoing hemodialysis are at higher risk for acquiring this infection. Management of HCV infection in these patient groups is complicated by multiple side effects including flu-like symptoms, neutropenia, fever, neuro-psychiatric disorders etc., thus limiting the use of ribavirin and coexisting iron overload. In HCV patients suffering from depression, the treatment is discontinued due to some defects in neurochemical pathways caused by interferon as it enhances the level of depression in these patients. While in case of obese patients having HCV infection, obesity has been found to be a marker of failure of HCV treatment. There will be many resistance tolerant HCV treatment options likely to be available in near future.