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Antiviral resistance in HCV strains isolated from Romanian patients with limited treatment options for chronic HCV infection
BMC Infectious Diseasesvolume 14, Article number: P8 (2014)
We performed a study to assess the antiviral resistance profile in a series of patients with limited treatment options for chronic HCV infection.
We assessed data from 12 patients (gender ratio 1:1), of which 10 had HCV monoinfection and 2 had HCV+HIV coinfection. The mean age was 43.8±16.5 years (range 19-71 years). Eleven patients were infected with HCV genotype 1b, and one patient had been coinfected with genotype 2a/2c but had spontaneously cleared 2a infection and was now monoinfected with HCV 2c.
Only one patient had IL28-B genotype CC, 4 patients CT and 5 patients TT (in two cases data on IL28-B were not available). Seven of the patients had received prior anti-HCV therapy: 2 with peg-interferon+ribavirin, 2 with faldaprevir-based regimens and 3 with telaprevir-based regimens. Of them, 3 had been non-responders and 4 had been relapsers.
The mean plasma HCV-RNA was 6.1±0.7 log10 IU/mL. Patients were distributed over the whole range of fibrosis values on FibroMax, with a slight predominance of advanced fibrosis: F3 (2 patients) and F4 (3 patients).
Resistance to boceprevir or simeprevir was identified in 3/12 cases (fold-change range: 4-24) and 2/12 cases (fold-change range: 32-38), respectively, although none of the patients had received prior therapy with these antivirals.
Resistance to telaprevir was identified in 3/12 cases (surprisingly, none of the cases with telaprevir therapy). Possible resistance was identified in another 6 cases (including cases treated with telaprevir and faldaprevir). The overall fold-change range was 1.8-22.4.
Resistance to faldaprevir was identified in 3/12 cases (surprisingly, none of the cases with faldaprevir therapy), with a fold-change range of 1.2-360.0.
Cross-resistance to HCV protease inhibitors (PI) remains a cause for concern, particularly in patients with history of treatment with HCV PI-based regimens.
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This paper is partially supported by the Sectoral Operational Programme Human Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government under the contract numbers POSDRU/159/1.5/S/137390.