Buckton A J, Kulasegaram R, Ngui S L, Fisher M, James R, Rangarajan S, Teo C G
Virus Reference Department, Centre for Infections, Health Protection Agency, London, UK.
J Clin Virol. 2007 Sep;40(1):60-3. doi: 10.1016/j.jcv.2007.05.010. Epub 2007 Jul 12.
An HIV-1/hepatitis C virus (HCV) co-infected patient with haemophilia received a 48-week course of pegylated interferon-alpha-2b and ribavirin therapy for genotype 5a HCV infection. Virological response was achieved at week 24. At the end of treatment, HCV RNA in serum was detected and identified to belong to genotype 2b, rather than genotype 5a. A sensitive method for identifying minority HCV genotypes in pre-treatment serum showed genotype 2b HCV carriage prior to treatment. Sequencing the interferon sensitivity-determining region of the HCV NS5A gene obtained from pre-, intra- and post-treatment sera revealed emergence of quasispecies bearing R-->K and M-->A/T mutations at codons 2222 and 2223, respectively. Occult presence of minority HCV subpopulations and their acquisition of mutations following therapy can result in poor treatment outcome.
一名感染人类免疫缺陷病毒1型（HIV-1）和丙型肝炎病毒（HCV）的血友病患者，因基因型5a HCV感染接受了为期48周的聚乙二醇化干扰素α-2b和利巴韦林治疗。在第24周时实现了病毒学应答。治疗结束时，检测到血清中的HCV RNA并鉴定其属于基因型2b，而非基因型5a。一种用于鉴定治疗前血清中少数HCV基因型的灵敏方法显示，治疗前存在基因型2b HCV携带情况。对从治疗前、治疗中和治疗后血清中获得的HCV NS5A基因的干扰素敏感性决定区进行测序，结果显示分别在密码子2222和2223处出现了携带R→K和M→A/T突变的准种。少数HCV亚群的隐匿存在及其在治疗后获得的突变可能导致治疗效果不佳。
