Detection of a genetic footprint of the sofosbuvir resistance-associated substitution S282T after HCV treatment failure View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-06-08

AUTHORS

Andreas Walker, Sandra Filke, Nadine Lübke, Martin Obermeier, Rolf Kaiser, Dieter Häussinger, Jörg Timm, Hans H. Bock

ABSTRACT

BackgroundThe major resistance-associated substitution for sofosbuvir (S282T) in HCV NS5B causes severe viral fitness costs and rapidly reverts back to prototype in the absence of selection pressure. Accordingly, resistance against sofosbuvir is rarely detected even in patients after treatment failure.Case presentationWe report a case of a GT3a infected patient with viral breakthrough under SOF/DCV therapy. At the time of breakthrough the RAS S282T was predominant in NS5B and then rapidly disappeared during follow-up by week 12 after treatment. Interestingly, despite only serine was encoded in position 282 during follow-up, two distinct genetic pathways for reversion were detectable. In 31% of the quasispecies the original codon for serine was present whereas in the majority of the quasispecies an alternative codon was selected. This alternative codon usage was unique for all GT3a isolates from the HCV database and remained detectable as a genetic footprint for prior resistance selection at the RNA level for at least 6 months.ConclusionsComparative analyses of viral sequences at the codon level before and after DAA treatment may help to elucidate the patient’s history of resistance selection, which is particularly valuable for highly unfit substitutions that are detectable only for a short period of time. If such codon changes increase the risk of re-selection of resistance upon a second exposure to SOF remains to be addressed. More... »

PAGES

106

References to SciGraph publications

  • 2015-04-21. Treatment of hepatitis C in difficult-to-treat patients in NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
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    http://scigraph.springernature.com/pub.10.1186/s12985-017-0779-4

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    http://dx.doi.org/10.1186/s12985-017-0779-4

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    https://app.dimensions.ai/details/publication/pub.1085933310

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28595606


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