Fig. 2.

Micro-representation of direct-acting antiviral class resistance after failing first-line therapies.

A subset of virologic failures (n = 730) with sequences available from all 3 drug target genes (NS3, NS5A, and NS5B) were included for the analyses. Amino acid substitutions at all positions of the respective genes listed in the 2020 EASL recommendations on treatment of hepatitis C were included for the evaluation. PI RAS, NS5AI RAS, and NI RAS represent RASs selected in the HCV NS3, NS5A, and NS5B genes, respectively. Each circle represents the number of patients with detectable RAS in each drug class: purple, PI; green, NS5AI; and orange, NI. The size of the circle is proportional to the number of patients with detectable RASs. The intersecting regions represent dual- or triple-class resistance. NS5AI, NS5A inhibitor; NI, nucleoside inhibitor (sofosbuvir); PI, protease inhibitor; RASs, resistance-associated substitutions.