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      • Resistance Analyses for Ledipasvir/Sofosbuvir Containing Regimens in HCV-infected Patients Who Have Advanced Liver Disease or Are Post Liver Transplant

        ( Michael Charlton ),( Michael Manns ),( Hadas Dvory-sobol ),( Evguenia Svarovskaia ),( Brian Doehle ),( Sarah Arterburn ),( Chohee Yun ),( Diana M. Brainard ),( John G. Mchutchison ),( Michael Miller 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

        Aims: Ledipasvir/sofosbuvir (LDV/SOF) with ribavirin (RBV) demonstrated high SVR rates in patients with chronic hepatitis C (HCV) genotype (GT) 1 or 4 infection who have decompensated cirrhosis or who have undergone liver transplantation. Here we evaluated the effect of baseline HCV NS5A and NS5B resistance-associated variants (RAVs) on treatment outcome and characterized the viral resistance in all virologic failures. Methods: Deep sequencing with a 1% assay cut-off was performed for NS5A and NS5B at baseline for all the patients and at the time of virologic failure for those who relapsed. Results: Out of 625, 622, and 619 samples were analyzed for baseline NS5A and NS5B respectively. Table 1 summarizes SVR12 rates by treatment duration and the presence or absence of baseline NS5A RAVs. NS5B RAVs at baseline were uncommon, occurring in 4.8% (28/586) GT1 patients and 3.2% (1/31) GT 4 patients. Of these 29 patients, only one GT1 patient with CPT C cirrhosis who had L159F at baseline and was treated for 24 weeks with LDV/SOF+RBV did not achieve SVR12. NS5A RAVs at positions 24, 28, 30, 31, 58, and 93 were enriched or emerged in 20/22 (91%) GT1 and 1/3 GT4 infected patients with virologic failure. The NS5B NI RAV E237G emerged in 3 GT1a patients and 1 GT4d patient at the time of relapse (4/23, 17%). Conclusions: The presence of baseline NS5A or NS5B RAVs did not impact the treatment outcome to 12 or 24 weeks of LDV/SOF+RBV in GT1 or GT4 HCV patients with liver ransplantation without decompensated liver disease, or 24 weeks of LDV/SOF+RBV in patients with decompensated cirrhosis. Lower SVR rates were observed among the limited number of patients with decompensated cirrhosis and baseline NS5A RAVs who received 12 weeks of LDV/SOF+RBV treatment.

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        MULTI-SIGHTLINE OBSERVATION OF NARROW ABSORPTION LINES IN LENSED QUASAR SDSS J1029+2623

        Misawa, Toru,Saez, Cristian,Charlton, Jane C.,Eracleous, Michael,Chartas, George,Bauer, Franz E.,Inada, Naohisa,Uchiyama, Hisakazu American Astronomical Society 2016 The Astrophysical journal Vol.825 No.1

        <P>We exploit the widely separated images of the lensed quasar SDSS J1029+2623 (z(em) = 2.197, theta = 22.'' 5) to observe its outflowing wind through two different sightlines. We present an analysis of three observations, including two with the Subaru telescope in 2010 February and 2014 April, separated by four years, and one with the Very Large Telescope, separated from the second Subaru observation by similar to 2 months. We detect 66 narrow absorption lines (NALs), of which 24 are classified as intrinsic NALs that are physically associated with the quasar based on partial coverage analysis. The velocities of intrinsic NALs appear to cluster around values of v(ej) similar to 59,000, 43,000, and 29,000 km s(-1), which is reminiscent of filamentary structures obtained by numerical simulations. There are no common intrinsic NALs at the same redshift along the two sightlines, implying that the transverse size of the NAL absorbers should be smaller than the sightline distance between two lensed images. In addition to the NALs with large ejection velocities of v(ej) > 1000 km s(-1), we also detect broader proximity absorption lines (PALs) at za(bs) similar to z(em). The PALs are likely to arise in outflowing gas at a distance of r <= 620 pc from the central black hole with an electron density of n(e) >= 8.7 x 10(3) cm(-3). These limits are based on the assumption that the variability of the lines is due to recombination. We discuss the implications of these results on the three-dimensional structure of the outflow.</P>

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