Naturally occurring mutations associated with resistance to HCV NS5B polymerase and NS3 protease inhibitors in treatment-naïve patients with chronic hepatitis C
The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be important for their management and outcome prevision. In this study, we investigated the presence of mutations, which have been previously reported to b...
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Published in | Virology journal Vol. 12; no. 1; p. 186 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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BioMed Central
14.11.2015
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Abstract | The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be important for their management and outcome prevision. In this study, we investigated the presence of mutations, which have been previously reported to be associated with resistance to DAAs in HCV polymerase (NS5B) and HCV protease (NS3) regions, in sera of treatment-naïve patients.
HCV RNA from 152 naïve patients (84 % Italian and 16 % immigrants from various countries) infected with different HCV genotypes (21,1a; 21, 1b; 2, 2a; 60, 2c; 22, 3a; 25, 4d and 1, 4k) was evaluated for sequence analysis. Amplification and sequencing of fragments in the NS5B (nt 8256-8640) and NS3 (nt 3420-3960) regions of HCV genome were carried out for 152 and 28 patients, respectively. The polymorphism C316N/H in NS5B region, associated with resistance to sofosbuvir, was detected in 9 of the 21 (43 %) analysed sequences from genotype 1b-infected patients. Naturally occurring mutations V36L, and M175L in the NS3 protease region were observed in 100 % of patients infected with subtype 2c and 4.
A relevant proportion of treatment naïve genotype 1b infected patients evaluated in this study harboured N316 polymorphism and might poorly respond to sofosbuvir treatment. As sofosbuvir has been approved for treatment of HCV chronic infection in USA and Europe including Italy, pre-treatment testing for N316 polymorphism on genotype 1b naïve patients should be considered for this drug. |
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AbstractList | Background The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naive patients could be important for their management and outcome prevision. In this study, we investigated the presence of mutations, which have been previously reported to be associated with resistance to DAAs in HCV polymerase (NS5B) and HCV protease (NS3) regions, in sera of treatment-naive patients. Findings HCV RNA from 152 naive patients (84 % Italian and 16 % immigrants from various countries) infected with different HCV genotypes (21,1a; 21, 1b; 2, 2a; 60, 2c; 22, 3a; 25, 4d and 1, 4k) was evaluated for sequence analysis. Amplification and sequencing of fragments in the NS5B (nt 8256-8640) and NS3 (nt 3420-3960) regions of HCV genome were carried out for 152 and 28 patients, respectively. The polymorphism C316N/H in NS5B region, associated with resistance to sofosbuvir, was detected in 9 of the 21 (43 %) analysed sequences from genotype 1b-infected patients. Naturally occurring mutations V36L, and M175L in the NS3 protease region were observed in 100 % of patients infected with subtype 2c and 4. Conclusion A relevant proportion of treatment naive genotype 1b infected patients evaluated in this study harboured N316 polymorphism and might poorly respond to sofosbuvir treatment. As sofosbuvir has been approved for treatment of HCV chronic infection in USA and Europe including Italy, pre-treatment testing for N316 polymorphism on genotype 1b naive patients should be considered for this drug. BACKGROUNDThe detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be important for their management and outcome prevision. In this study, we investigated the presence of mutations, which have been previously reported to be associated with resistance to DAAs in HCV polymerase (NS5B) and HCV protease (NS3) regions, in sera of treatment-naïve patients. FINDINGSHCV RNA from 152 naïve patients (84 % Italian and 16 % immigrants from various countries) infected with different HCV genotypes (21,1a; 21, 1b; 2, 2a; 60, 2c; 22, 3a; 25, 4d and 1, 4k) was evaluated for sequence analysis. Amplification and sequencing of fragments in the NS5B (nt 8256-8640) and NS3 (nt 3420-3960) regions of HCV genome were carried out for 152 and 28 patients, respectively. The polymorphism C316N/H in NS5B region, associated with resistance to sofosbuvir, was detected in 9 of the 21 (43 %) analysed sequences from genotype 1b-infected patients. Naturally occurring mutations V36L, and M175L in the NS3 protease region were observed in 100 % of patients infected with subtype 2c and 4. CONCLUSIONA relevant proportion of treatment naïve genotype 1b infected patients evaluated in this study harboured N316 polymorphism and might poorly respond to sofosbuvir treatment. As sofosbuvir has been approved for treatment of HCV chronic infection in USA and Europe including Italy, pre-treatment testing for N316 polymorphism on genotype 1b naïve patients should be considered for this drug. The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be important for their management and outcome prevision. In this study, we investigated the presence of mutations, which have been previously reported to be associated with resistance to DAAs in HCV polymerase (NS5B) and HCV protease (NS3) regions, in sera of treatment-naïve patients. HCV RNA from 152 naïve patients (84 % Italian and 16 % immigrants from various countries) infected with different HCV genotypes (21,1a; 21, 1b; 2, 2a; 60, 2c; 22, 3a; 25, 4d and 1, 4k) was evaluated for sequence analysis. Amplification and sequencing of fragments in the NS5B (nt 8256-8640) and NS3 (nt 3420-3960) regions of HCV genome were carried out for 152 and 28 patients, respectively. The polymorphism C316N/H in NS5B region, associated with resistance to sofosbuvir, was detected in 9 of the 21 (43 %) analysed sequences from genotype 1b-infected patients. Naturally occurring mutations V36L, and M175L in the NS3 protease region were observed in 100 % of patients infected with subtype 2c and 4. A relevant proportion of treatment naïve genotype 1b infected patients evaluated in this study harboured N316 polymorphism and might poorly respond to sofosbuvir treatment. As sofosbuvir has been approved for treatment of HCV chronic infection in USA and Europe including Italy, pre-treatment testing for N316 polymorphism on genotype 1b naïve patients should be considered for this drug. |
ArticleNumber | 186 |
Author | Equestre, Michele Sagnelli, Caterina Tritarelli, Elena Ciccaglione, Anna Rita Bruni, Roberto Coppola, Nicola Sagnelli, Evangelista Spada, Enea Costantino, Angela |
Author_xml | – sequence: 1 givenname: Angela surname: Costantino fullname: Costantino, Angela email: angela.costantino@iss.it organization: Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. angela.costantino@iss.it – sequence: 2 givenname: Enea surname: Spada fullname: Spada, Enea email: enea.spada@iss.it organization: Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. enea.spada@iss.it – sequence: 3 givenname: Michele surname: Equestre fullname: Equestre, Michele email: michele.equestre@iss.it organization: Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy. michele.equestre@iss.it – sequence: 4 givenname: Roberto surname: Bruni fullname: Bruni, Roberto email: roberto.bruni@iss.it organization: Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. roberto.bruni@iss.it – sequence: 5 givenname: Elena surname: Tritarelli fullname: Tritarelli, Elena email: elena.tritarelli@iss.it organization: Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. elena.tritarelli@iss.it – sequence: 6 givenname: Nicola surname: Coppola fullname: Coppola, Nicola email: nicola.coppola@unina2.it organization: Department of Mental Health and Public Medicine, Section of Infectious diseases, Second University of Naples, Naples, Italy. nicola.coppola@unina2.it – sequence: 7 givenname: Caterina surname: Sagnelli fullname: Sagnelli, Caterina email: sagnelli.caterina@libero.it organization: Department of Experimental Medicine and Surgery F. Magrassi and A. Lanzara, Second University of Naples, Naples, Italy. sagnelli.caterina@libero.it – sequence: 8 givenname: Evangelista surname: Sagnelli fullname: Sagnelli, Evangelista email: Evangelista.SAGNELLI@unina2.it organization: Department of Mental Health and Public Medicine, Section of Infectious diseases, Second University of Naples, Naples, Italy. Evangelista.SAGNELLI@unina2.it – sequence: 9 givenname: Anna Rita surname: Ciccaglione fullname: Ciccaglione, Anna Rita email: annarita.ciccaglione@iss.it organization: Department of Infectious, Parasitic and Immune-Mediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161, Rome, Italy. annarita.ciccaglione@iss.it |
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Snippet | The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be important... Background The detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naive patients could be... BACKGROUNDThe detection of baseline resistance mutations to new direct-acting antivirals (DAAs) in HCV chronically infected treatment-naïve patients could be... |
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SubjectTerms | Adult Aged Aged, 80 and over Antiviral Agents - pharmacology Drug Resistance, Viral Emigrants and Immigrants Hepacivirus - drug effects Hepacivirus - genetics Hepacivirus - isolation & purification Hepatitis C, Chronic - epidemiology Hepatitis C, Chronic - virology Humans Italy Male Middle Aged Mutation, Missense Polymorphism, Genetic Protease Inhibitors - pharmacology RNA, Viral - blood RNA, Viral - genetics RNA, Viral - isolation & purification Sequence Analysis, DNA Short Report Sofosbuvir - pharmacology Viral Nonstructural Proteins - genetics Young Adult |
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Title | Naturally occurring mutations associated with resistance to HCV NS5B polymerase and NS3 protease inhibitors in treatment-naïve patients with chronic hepatitis C |
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