AIDS Research Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California 94304, USA.
J Infect Dis. 2010 Sep 15;202(6):889-93. doi: 10.1086/655784.
Patients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection for whom prior treatment of HCV with interferon-ribavirin has failed may require subsequent treatment with new HCV protease inhibitors (PIs). We evaluated the diversity of HCV nonstructural protein 3 (NS3) in 26 HCV- and HIV-coinfected patients receiving stable antiretroviral therapy (ART) who were treated with interferon-ribavirin. Plasma HCV RNA clonal analysis was performed. There was greater baseline NS3 diversity in patients with nonresponse or relapse than in those with sustained virologic response. Interferon-ribavirin treatment did not result in significant changes in HCV protease gene diversity or significant HCV PI resistance mutations. The effect of prior interferon-ribavirin treatment on HCV NS3 will likely not impact HCV PI efficacy in HIV-coinfected patients receiving ART.
慢性丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）合并感染患者，若既往干扰素-利巴韦林治疗失败，可能需要后续使用新型 HCV 蛋白酶抑制剂（PI）治疗。我们评估了 26 例慢性丙型肝炎病毒和 HIV 合并感染患者的 HCV 非结构蛋白 3（NS3）多样性，这些患者正在接受稳定的抗逆转录病毒治疗（ART），并接受了干扰素-利巴韦林治疗。对患者的血浆 HCV RNA 进行了克隆分析。无应答或复发患者的基线 NS3 多样性明显高于持续病毒学应答患者。干扰素-利巴韦林治疗并未导致 HCV 蛋白酶基因多样性发生显著变化，也未导致显著的 HCV PI 耐药突变。既往干扰素-利巴韦林治疗对 HCV NS3 的影响可能不会影响接受 ART 的 HIV 合并感染患者的 HCV PI 疗效。
