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Hepatitis C disease approximately affects 200 000 people every day. It’s a monocatenary virus which is wrapped, small-sized and belongs to the Flaviviridae family. It presents a high genetic variability. There are actually 6 genotypes going from 1 to 6 and sub-genotypes (a and b). Time is incubation is very variable; it can achieve 26 weeks. We can see a big fatigue, an icterus and abdominal pains. Disease can evolve into a fibrosis even a cirrhosis. The first available treatment, since 1990 is the interferon associated with ribavirine. This treatment is very badly tolerated by the patients. It presents too many side effects among fatigue, headaches, myalgias even haematological disorders. Then appeared inhibitors of the protease NS3/4A, boceprevir, telaprevir and simeprevir; NS5A’S inhibitors, ledipasvir and dactalasvir ; and sofosbuvir, which is the ARN polymerase NS5B’s inhibitor. Treatment’s choice depends on the genotype. Some treatments can end in failures because of patient’s lack of compliance or resistances. Sofosbuvir possesses the highest barrier of resistance, contrary to protease’s inhibitors. To avoid failures, combination therapies are recommended with sofosbuvir or ribavirine. For each class of medicine, it’s necessary to know the transfers having a clinical impact to optimize the treatment. However searching for mutations is not systematic. It also depends on the genotype. Furthermore, mutations can persist after stopping treatment and others can return to wild origin, like telaprevir. Research for mutations causing resistance must be individually studied. L’hépatite C touche environ 200 000 personnes chaque année. C’est un virus à ARN monocaténaire, enveloppé, de petite taille qui appartient à la famille des Flaviviridae. Il présente une grande variabilité génétique. Il existe 6 génotypes allant de 1 à 6 et des sous-génotypes ( a et b). Le temps d’incubation est très variable peut atteindre 26 semaines. Cela se manifeste par une grande fatigue, un ictère et des douleurs abdominales. La maladie peut évoluer vers une fibrose voire une cirrhose. Le premier traitement disponible, depuis 1990 est l’interféron associé à la ribavirine. Ce traitement est très mal toléré par les patients. Il présente trop d’effets secondaires dont la fatigue, des maux de tête, des myalgies voire des troubles hématologiques. Ensuite, sont apparus les inhibiteurs de la protéase NS3/4A : le boceprevir, le telaprevir et le simeprevir ; les inhibiteurs de la NS5A : le ledispavir et le daclatasvir ; et le sofosbuvir : inhibiteur de l’ARN polymerase NS5B. Le choix du traitement dépend du génotype. Ces traitements peuvent parfois aboutir à des échecs à cause du manque de compliance du patient ou de résistances. Le sofosbuvir possède la barrière de résistance la plus élevée, contrairement aux inhibiteurs de la protéase. Pour contrecarrer les échecs, des associations médicamenteuses sont recommandées avec le sofosbuvir ou la ribavirine. Pour chaque classe de médicament, il est nécessaire de connaître les mutations ayant un impact systématique. Cela dépend du génotype. De plus, certaines mutations persistent après l’arrêt du traitement et d’autres retournent à la souche sauvage, c’est le cas du telaprevir. L’utilité de la recherche de mutations provoquent des résistances est à étudier au cas par cas.

Hepatitis C --- Drug Resistance, Viral

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Virology --- Antiviral agents --- Virus diseases --- Viruses --- Drug Resistance, Viral. --- Virus Diseases --- Antiviral Agents. --- Immunological aspects --- Variation --- therapy. --- Microbiology & Immunology

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Virology --- Antiviral agents --- Virus diseases --- Viruses --- Drug Resistance, Viral. --- Virus Diseases --- Antiviral Agents. --- Virology. --- Antiviral agents. --- Microbiology & Immunology --- Immunological aspects --- Variation --- therapy. --- Immunological aspects. --- Variation.

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Anti-Retroviral Agents --- Drug Resistance, Microbial --- Sexually Transmitted Diseases, Viral --- HIV --- Drug Evaluation, Preclinical --- Immunologic Deficiency Syndromes --- Lentivirus Infections --- Virus Physiological Phenomena --- Microbiological Techniques --- Microbiological Phenomena --- Lentiviruses, Primate --- Evaluation Studies as Topic --- Drug Resistance --- Immune System Diseases --- Clinical Laboratory Techniques --- Retroviridae Infections --- Sexually Transmitted Diseases --- Antiviral Agents --- RNA Virus Infections --- Lentivirus --- Anti-Infective Agents --- Investigative Techniques --- Virus Diseases --- Phenomena and Processes --- Pharmacological Phenomena --- Diseases --- Retroviridae --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Physiological Phenomena --- Therapeutic Uses --- Pharmacologic Actions --- RNA Viruses --- Viruses --- Chemical Actions and Uses --- Vertebrate Viruses --- Chemicals and Drugs --- Organisms --- Microbial Sensitivity Tests --- Drug Resistance, Viral --- HIV Infections --- HIV-1 --- Anti-HIV Agents --- Microbial Sensitivity Tests. --- Drug Resistance, Viral. --- drug therapy. --- drug effects. --- pharmacoloogy.

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Human medicine --- Hepatitis, Viral, Human --- Liver Neoplasms --- Flaviviridae Infections --- Drug Resistance, Microbial --- Virus Physiological Phenomena --- Hepadnaviridae Infections --- Adenocarcinoma --- Carcinoma, Hepatocellular --- Hepatitis C --- Drug Resistance, Viral --- Hepatitis B --- Hepatitis --- Microbiological Phenomena --- Digestive System Neoplasms --- Drug Resistance --- Virus Diseases --- Carcinoma --- DNA Virus Infections --- RNA Virus Infections --- Liver Diseases --- Digestive System Diseases --- Neoplasms by Site --- Diseases --- Phenomena and Processes --- Neoplasms, Glandular and Epithelial --- Pharmacological Phenomena --- Neoplasms --- Neoplasms by Histologic Type --- Physiological Phenomena --- Medicine --- Gastroenterology --- Health & Biological Sciences --- Physiological Concepts --- Physiological Phenomenon --- Physiological Process --- Physiological Processes --- Concept, Physiological --- Concepts, Physiological --- Phenomena, Physiological --- Phenomenas, Physiological --- Phenomenon, Physiological --- Physiological Concept --- Process, Physiological --- Processes, Physiological --- Histological Type of Neoplasm --- Histological Types of Neoplasms --- Neoplasms by Histological Type --- Neoplasm Histological Type --- Neoplasm Histological Types --- Neoplasms Histological Type --- Neoplasms Histological Types --- Benign Neoplasms --- Malignancy --- Malignant Neoplasms --- Neoplasia --- Neoplasm --- Neoplasms, Benign --- Cancer --- Tumors --- Benign Neoplasm --- Cancers --- Malignancies --- Malignant Neoplasm --- Neoplasias --- Neoplasm, Benign --- Neoplasm, Malignant --- Neoplasms, Malignant --- Tumor --- Medical Oncology --- Pharmacologic Phenomena --- Pharmacologic Phenomenon --- Pharmacologic Process --- Pharmacological Concepts --- Pharmacological Phenomenon --- Pharmacologic Processes --- Pharmacological Processes --- Concept, Pharmacological --- Concepts, Pharmacological --- Pharmacological Concept --- Phenomena, Pharmacologic --- Phenomena, Pharmacological --- Phenomenon, Pharmacologic --- Phenomenon, Pharmacological --- Process, Pharmacologic --- Processes, Pharmacologic --- Processes, Pharmacological --- Epithelial Neoplasms --- Glandular Neoplasms --- Glandular and Epithelial Neoplasms --- Neoplasms, Epithelial --- Neoplasms, Glandular --- Neoplasms, Glandular Epithelial --- Epithelial Neoplasm --- Epithelial Neoplasm, Glandular --- Epithelial Neoplasms, Glandular --- Glandular Epithelial Neoplasm --- Glandular Epithelial Neoplasms --- Glandular Neoplasm --- Neoplasm, Epithelial --- Neoplasm, Glandular --- Neoplasm, Glandular Epithelial --- Neoplasms by Sites --- Site, Neoplasm --- Sites, Neoplasm --- Neoplasm Site --- Neoplasm Sites --- Digestive System Disorders --- Hepatobiliary Diseases --- Hepatobiliary Disorders --- Digestive System Disease --- Digestive System Disorder --- Hepatobiliary Disease --- Hepatobiliary Disorder --- System Disorders, Digestive --- Liver Dysfunction --- Disease, Liver --- Diseases, Liver --- Dysfunction, Liver --- Dysfunctions, Liver --- Liver Disease --- Liver Dysfunctions --- Infections, RNA Virus --- Infection, RNA Virus --- RNA Virus Infection --- Virus Infection, RNA --- Virus Infections, RNA --- Infections, DNA Virus --- DNA Virus Infection --- Infection, DNA Virus --- Virus Infection, DNA --- Virus Infections, DNA --- Epithelial Tumors, Malignant --- Malignant Epithelial Neoplasms --- Neoplasms, Malignant Epithelial --- Carcinoma, Anaplastic --- Carcinoma, Spindle-Cell --- Carcinoma, Undifferentiated --- Carcinomatosis --- Epithelial Neoplasms, Malignant --- Epithelioma --- Anaplastic Carcinoma --- Anaplastic Carcinomas --- Carcinoma, Spindle Cell --- Carcinomas --- Carcinomatoses --- Epithelial Neoplasm, Malignant --- Epithelial Tumor, Malignant --- Epitheliomas --- Malignant Epithelial Neoplasm --- Malignant Epithelial Tumor --- Malignant Epithelial Tumors --- Neoplasm, Malignant Epithelial --- Spindle-Cell Carcinoma --- Spindle-Cell Carcinomas --- Tumor, Malignant Epithelial --- Undifferentiated Carcinoma --- Undifferentiated Carcinomas --- Viral Diseases --- Viral Infections --- Virus Infections --- Disease, Viral --- Disease, Virus --- Diseases, Viral --- Diseases, Virus --- Infection, Viral --- Infection, Virus --- Infections, Viral --- Infections, Virus --- Viral Disease --- Viral Infection --- Virus Disease --- Virus Infection --- Resistance, Drug --- Pharmacogenetics --- Cancer of the Digestive System --- Neoplasms, Digestive System --- Cancer of Digestive System --- Digestive System Cancer --- Cancer, Digestive System --- Cancers, Digestive System --- Digestive System Cancers --- Digestive System Neoplasm --- Neoplasm, Digestive System --- Microbial Concepts --- Microbial Phenomena --- Microbiologic Concepts --- Microbiological Phenomenon --- Microbiological Process --- Phenomena, Microbiologic --- Microbiologic Phenomena --- Microbiological Processes --- Concept, Microbial --- Concept, Microbiologic --- Concepts, Microbial --- Concepts, Microbiologic --- Microbial Concept --- Microbiologic Concept --- Phenomena, Microbial --- Phenomena, Microbiological --- Phenomenon, Microbiological --- Process, Microbiological --- Processes, Microbiological --- Dysbiosis --- Hepatitides --- Hepatitis B Virus Infection --- Antiviral Drug Resistance --- Antiviral Drug Resistances --- Drug Resistances, Viral --- PT-NANBH --- Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted --- Parenterally-Transmitted Non-A, Non-B Hepatitis --- Parenterally Transmitted Non A, Non B Hepatitis --- Liver Cancer, Adult --- Liver Cell Carcinoma --- Liver Cell Carcinoma, Adult --- Hepatocellular Carcinoma --- Hepatoma --- Adult Liver Cancer --- Adult Liver Cancers --- Cancer, Adult Liver --- Cancers, Adult Liver --- Carcinoma, Liver Cell --- Carcinomas, Hepatocellular --- Carcinomas, Liver Cell --- Cell Carcinoma, Liver --- Cell Carcinomas, Liver --- Hepatocellular Carcinomas --- Hepatomas --- Liver Cancers, Adult --- Liver Cell Carcinomas --- Adenocarcinoma, Basal Cell --- Adenocarcinoma, Granular Cell --- Adenocarcinoma, Oxyphilic --- Adenocarcinoma, Tubular --- Adenoma, Malignant --- Carcinoma, Cribriform --- Carcinoma, Granular Cell --- Carcinoma, Tubular --- Adenocarcinomas --- Adenocarcinomas, Basal Cell --- Adenocarcinomas, Granular Cell --- Adenocarcinomas, Oxyphilic --- Adenocarcinomas, Tubular --- Adenomas, Malignant --- Basal Cell Adenocarcinoma --- Basal Cell Adenocarcinomas --- Carcinomas, Cribriform --- Carcinomas, Granular Cell --- Carcinomas, Tubular --- Cribriform Carcinoma --- Cribriform Carcinomas --- Granular Cell Adenocarcinoma --- Granular Cell Adenocarcinomas --- Granular Cell Carcinoma --- Granular Cell Carcinomas --- Malignant Adenoma --- Malignant Adenomas --- Oxyphilic Adenocarcinoma --- Oxyphilic Adenocarcinomas --- Tubular Adenocarcinoma --- Tubular Adenocarcinomas --- Tubular Carcinoma --- Tubular Carcinomas --- Carcinoma, Non-Small-Cell Lung --- Infections, Hepadnaviridae --- Hepadnaviridae Infection --- Infection, Hepadnaviridae --- Physiology, Viral --- Viral Physiological Concepts --- Viral Physiological Phenomena --- Viral Physiological Process --- Virus Physiological Concepts --- Virus Physiological Phenomenon --- Virus Physiological Process --- Virus Physiology --- Viral Physiological Processes --- Viral Physiology --- Virus Physiological Processes --- Concept, Viral Physiological --- Concept, Virus Physiological --- Concepts, Viral Physiological --- Concepts, Virus Physiological --- Phenomena, Viral Physiological --- Phenomena, Virus Physiological --- Phenomenon, Virus Physiological --- Phenomenons, Virus Physiological --- Physiological Process, Viral --- Physiological Process, Virus --- Physiological Processes, Viral --- Physiological Processes, Virus --- Physiology, Virus --- Process, Viral Physiological --- Process, Virus Physiological --- Processes, Viral Physiological --- Processes, Virus Physiological --- Viral Physiological Concept --- Virus Physiological Concept --- Viruses --- Antimicrobial Drug Resistance --- Antibiotic Resistance --- Antibiotic Resistance, Microbial --- Antimicrobial Drug Resistances --- Drug Resistances, Microbial --- Resistance, Antibiotic --- Microbial Sensitivity Tests --- Infections, Flaviviridae --- Flaviviridae Infection --- Infection, Flaviviridae --- Cancer of the Liver --- Cancer, Hepatocellular --- Hepatic Neoplasms --- Hepatocellular Cancer --- Neoplasms, Hepatic --- Neoplasms, Liver --- Cancer of Liver --- Hepatic Cancer --- Liver Cancer --- Cancer, Hepatic --- Cancer, Liver --- Cancers, Hepatic --- Cancers, Hepatocellular --- Cancers, Liver --- Hepatic Cancers --- Hepatic Neoplasm --- Hepatocellular Cancers --- Liver Cancers --- Liver Neoplasm --- Neoplasm, Hepatic --- Neoplasm, Liver --- Viral Hepatitis, Human --- Human Viral Hepatitides --- Human Viral Hepatitis --- Viral Hepatitides, Human --- physiology --- Epithelial Cell Neoplasms --- Glandular Cell Neoplasms --- Cell Neoplasm, Epithelial --- Cell Neoplasm, Glandular --- Cell Neoplasms, Epithelial --- Epithelial Cell Neoplasm --- Glandular Cell Neoplasm --- Neoplasm, Epithelial Cell --- Neoplasm, Glandular Cell