Resistance analysis of genotype 3 hepatitis C virus indicates subtypes inherently resistant to nonstructural protein 5A inhibitors.


Journal

Hepatology (Baltimore, Md.)
ISSN: 1527-3350
Titre abrégé: Hepatology
Pays: United States
ID NLM: 8302946

Informations de publication

Date de publication:
05 2019
Historique:
received: 18 09 2017
accepted: 03 02 2018
pubmed: 10 2 2018
medline: 17 6 2020
entrez: 10 2 2018
Statut: ppublish

Résumé

Hepatitis C virus (HCV) genotype (gt) 3 is highly prevalent globally, with non-gt3a subtypes common in Southeast Asia. Resistance-associated substitutions (RASs) have been shown to play a role in treatment failure. However, the role of RASs in gt3 is not well understood. We report the prevalence of RASs in a cohort of direct-acting antiviral treatment-naive, gt3-infected patients, including those with rarer subtypes, and evaluate the effect of these RASs on direct-acting antivirals in vitro. Baseline samples from 496 gt3 patients enrolled in the BOSON clinical trial were analyzed by next-generation sequencing after probe-based enrichment for HCV. Whole viral genomes were analyzed for the presence of RASs to approved direct-acting antivirals. The resistance phenotype of RASs in combination with daclatasvir, velpatasvir, pibrentasvir, elbasvir, and sofosbuvir was measured using the S52 ΔN gt3a replicon model. The nonstructural protein 5A A30K and Y93H substitutions were the most common at 8.9% (n = 44) and 12.3% (n = 61), respectively, and showed a 10-fold and 11-fold increase in 50% effect concentration for daclatasvir compared to the unmodified replicon. Paired RASs (A30K + L31M and A30K + Y93H) were identified in 18 patients (9 of each pair); these combinations were shown to be highly resistant to daclatasvir, velpatasvir, elbasvir, and pibrentasvir. The A30K + L31M combination was found in all gt3b and gt3g samples. Conclusion: Our study reveals high frequencies of RASs to nonstructural protein 5A inhibitors in gt3 HCV; the paired A30K + L31M substitutions occur in all patients with gt3b and gt3g virus, and in vitro analysis suggests that these subtypes may be inherently resistant to all approved nonstructural protein 5A inhibitors for gt3 HCV. (Hepatology 2018).

Identifiants

pubmed: 29425396
doi: 10.1002/hep.29837
pmc: PMC6492296
doi:

Substances chimiques

Antiviral Agents 0
Carbamates 0
Imidazoles 0
Pyrrolidines 0
Viral Nonstructural Proteins 0
NS-5 protein, hepatitis C virus EC 2.7.7.48
Valine HG18B9YRS7
daclatasvir LI2427F9CI
Sofosbuvir WJ6CA3ZU8B

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1861-1872

Subventions

Organisme : Department of Health
ID : 14/02/17
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K01532X/1
Pays : United Kingdom
Organisme : Department of Health
ID : RP-2016-07-012
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 090532/Z/09/Z
Pays : United Kingdom

Informations de copyright

© 2018 The Authors. Hepatology published by Wiley Periodicals, Inc. on behalf of American Association for the Study of Liver Diseases.

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Auteurs

David Smith (D)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.

Andrea Magri (A)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.
Oxford Martin School, University of Oxford, Oxford, UK.

David Bonsall (D)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.
Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Camilla L C Ip (CLC)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.
Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Amy Trebes (A)

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Anthony Brown (A)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.

Palo Piazza (P)

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Rory Bowden (R)

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Dung Nguyen (D)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.

M Azim Ansari (MA)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.
Oxford Martin School, University of Oxford, Oxford, UK.

Peter Simmonds (P)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.

Eleanor Barnes (E)

Nuffield Department of Medicine and the Oxford NIHR BRC, University of Oxford, Oxford, UK.

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Classifications MeSH