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中国初治的1b型丙型肝炎病毒感染患者中直接抗病毒药物的耐药相关多态性

Direct-acting Antiviral Agents Resistance-associated Polymorphisms in Chinese Treatment-naïve Patients Infected with Genotype 1b Hepatitis C Virus.

作者信息

Wang Ye, Rao Hui-Ying, Xie Xing-Wang, Wei Lai

机构信息

Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Disease, Beijing 100044, China.

出版信息

Chin Med J (Engl). 2015 Oct 5;128(19):2625-31. doi: 10.4103/0366-6999.166038.

Abstract

BACKGROUND

It has been reported that several baseline polymorphisms of direct-acting antivirals (DAAs) agents resistance-associated variants (RAVs) would affect the treatment outcomes of patients chronically infected with hepatitis C virus (CHC). The aim of this study is to investigate the prevalence of DAAs RAVs in treatment-naÏve GT1b CHC patients.

METHODS

Direct sequencing and ultra-deep sequencing of the HCV NS3, NS5A, and NS5B gene were performed in baseline serum samples of treatment-naÏve patients infected with genotype 1b hepatitis C virus (HCVs).

RESULTS

One hundred and sixty CHC patients were studied. Complete sequence information was obtained for 145 patients (NS3), 148 patients (NS5A), and 137 patients (NS5B). Treatment-failure associated variants of DAAs were detected: 56.6% (82/145) of the patients presented S122G for simeprevir (NS3 protease inhibitor); 10.1% (14/148) of the patients presented Y93H for daclatasvir and ledipasvir (NS5A protein inhibitors); 94.2% (129/137) of the patients presented C316N for sofosbuvir (NS5B polymerase inhibitor). Nearly, all of the DAAs RAVs detected by ultra-deep sequencing could be detected by direct sequencing.

CONCLUSIONS

The majority of genotype 1b CHC patients in China present a virus population carrying HCV DAAs RAVs. Pretreatment sequencing of HCV genome might need to be performed when patients infected with GT1b HCV receiving DAAs-containing regimens in China. Population sequencing would be quite quantified for the work.

摘要

背景

据报道,直接抗病毒药物(DAAs)耐药相关变异(RAVs)的几种基线多态性会影响丙型肝炎病毒(CHC)慢性感染患者的治疗结果。本研究的目的是调查初治GT1b型CHC患者中DAAs RAVs的流行情况。

方法

对初治的1b型丙型肝炎病毒(HCV)感染患者的基线血清样本进行HCV NS3、NS5A和NS5B基因的直接测序和超深度测序。

结果

共研究了160例CHC患者。获得了145例患者(NS3)、148例患者(NS5A)和137例患者(NS5B)的完整序列信息。检测到DAAs的治疗失败相关变异:56.6%(82/145)的患者出现simeprevir(NS3蛋白酶抑制剂)的S122G变异;10.1%(14/148)的患者出现daclatasvir和ledipasvir(NS5A蛋白抑制剂)的Y93H变异;94.2%(129/137)的患者出现sofosbuvir(NS5B聚合酶抑制剂)的C316N变异。几乎所有通过超深度测序检测到的DAAs RAVs都可以通过直接测序检测到。

结论

中国大多数1b型CHC患者存在携带HCV DAAs RAVs的病毒群体。在中国,感染GT1b型HCV的患者接受含DAAs方案治疗时,可能需要进行HCV基因组的治疗前测序。群体测序对于这项工作将具有相当的量化作用。

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