Universität zu Köln

Walker, Andreas ORCID: 0000-0002-8736-0863, Filke, Sandra, Luebke, Nadine, Obermeier, Martin, Kaiser, Rolf, Haeussinger, Dieter, Timm, Joerg and Bock, Hans H. (2017). Detection of a genetic footprint of the sofosbuvir resistance-associated substitution S282T after HCV treatment failure. Virol. J., 14. LONDON: BMC. ISSN 1743-422X

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Abstract

Background: The 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 presentation: We 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. Conclusions: Comparative 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Walker, Andreas UNSPECIFIED orcid.org/0000-0002-8736-0863 UNSPECIFIED Filke, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Luebke, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Obermeier, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaiser, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Haeussinger, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Timm, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Bock, Hans H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-227909
DOI:	10.1186/s12985-017-0779-4
Journal or Publication Title:	Virol. J.
Volume:	14
Date:	2017
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1743-422X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language C VIRUS-RESISTANCE; HEPATITIS-C; NATURAL PREVALENCE; ANTIVIRAL DRUGS; GENOTYPE 3; NS5A; VARIANTS; DACLATASVIR; INFECTION Multiple languages Virology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22790