Case report: Identification of recombinant HCV genotype 1b–2b by viral sequencing in two patients with treatment failure, who responded to re-treatment with sofosbuvir and daclatasvir

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 24; no. 11; pp. 928 - 931
• Main Authors: Uribe-Noguez, Luis Antonio, Ocaña-Mondragón, Alicia, Mata-Marín, José Antonio, Cázares-Cortázar, Allison, Ribas-Aparicio, Rosa María, Gómez-Torres, María Elena, Gaytán-Martínez, Jesus, Martínez-Rodríguez, María de la Luz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2018
• Subjects: Adult; Antiviral Agents - therapeutic use; Drug Therapy, Combination - methods; Female; Genotype 1b-2b; Genotyping Techniques; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepatitis C - drug therapy; Hepatitis C - virology; Hepatitis C virus; Humans; Imidazoles - therapeutic use; Male; Middle Aged; Phylogenetic analysis; Recombination; Retreatment - methods; RNA, Viral - isolation & purification; Sequence Analysis, RNA; Sequencing; Sofosbuvir - therapeutic use; Sustained Virologic Response; Treatment Failure; Viral Nonstructural Proteins - genetics; Phylogenetic analysis; Recombination; Genotype 1b-2b; Hepatitis C virus; Sequencing
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2018.04.001

Hepatitis C virus (HCV) infection is a global health problem. HCV has been classified into seven genotypes and >67 subtypes. Genotyping is necessary to enable selection of appropriate treatments. The commercial molecular techniques currently used do not identify some HCV subtypes, mixed infections and recombinant forms. In this study, the core–E1 and NS5B regions were sequenced and phylogenetically analysed to identify infections by HCV recombinant genotype 1b–2b in two patients who had initially been diagnosed with HCV genotype 2 infection by reverse hybridization with a Versant HCV Genotype 2.0 Assay. Response to treatment was monitored by viral kinetics. Therapeutic failure occurred with initial treatment with PEGylated interferon-α2b and ribavirin, but the use of sofosbuvir and daclatasvir on a re-treatment regimen after reclassification of the infecting virus resulted in a sustained virologic response. The use of a sequencing approach in treatment-naïve infected patients could enable physicians to select the optimal therapy and avoid possible relapses and adverse reactions associated with antiviral therapy.