Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven , Leuven , Belgium.
Department of Medical Virology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran.
Crit Rev Clin Lab Sci. 2019 Sep;56(6):420-434. doi: 10.1080/10408363.2019.1637394. Epub 2019 Jul 18.
While the prospect of viral cure is higher than ever for individuals infected with the hepatitis C virus (HCV) due to ground-breaking progress in antiviral treatment, success rates are still negatively influenced by HCV's high genetic variability. This genetic diversity is represented in the circulation of various genotypes and subtypes, mixed infections, recombinant forms and the presence of numerous drug resistant variants among infected individuals. Common misclassifications by commercial genotyping assays in combination with the limitations of currently used targeted population sequencing approaches have encouraged researchers to exploit alternative methods for the clinical management of HCV infections. Next-generation sequencing (NGS), a revolutionary and powerful tool with a variety of applications in clinical virology, can characterize viral diversity and depict viral dynamics in an ultra-wide and ultra-deep manner. The level of detail it provides makes it the method of choice for the diagnosis and clinical assessment of HCV infections. The sequence library provided by NGS is of a higher magnitude and sensitivity than data generated by conventional methods. Therefore, these technologies are helpful to guide clinical practice and at the same time highly valuable for epidemiological studies. The decreasing costs of NGS to determine genotypes, mixed infections, recombinant strains and drug resistant variants will soon make it feasible to employ NGS in clinical laboratories, to assist in the daily care of patients with HCV.
由于抗病毒治疗的突破性进展，感染丙型肝炎病毒 (HCV) 的个体的病毒治愈前景空前提高，但 HCV 高度的遗传变异性仍然对成功率产生负面影响。这种遗传多样性体现在各种基因型和亚型的循环、混合感染、重组形式以及感染个体中存在大量耐药变异体。商业基因分型检测的常见错误分类以及当前使用的靶向人群测序方法的局限性，促使研究人员探索替代方法来进行 HCV 感染的临床管理。下一代测序 (NGS) 是一种革命性的强大工具，在临床病毒学中有多种应用，能够以超宽和超深的方式描述病毒多样性和病毒动力学。它提供的详细程度使其成为 HCV 感染诊断和临床评估的首选方法。NGS 提供的序列库比传统方法生成的数据具有更高的幅度和灵敏度。因此，这些技术有助于指导临床实践，同时对流行病学研究也具有很高的价值。确定基因型、混合感染、重组株和耐药变异体的 NGS 成本不断降低，不久将使 NGS 在临床实验室中得以应用，从而有助于日常护理 HCV 患者。
