Naturally Occurring Resistance Associated Substitutions in Non-Cirrhotic, Treatment Naive HCV–HIV Co-Infected Patients Does Not Affect the Treatment Response for Anti-HCV Antiviral Therapy

Abstract

Purpose Limited literature on the prevalence of baseline resistance associated substitutions (BL-RAS) among HCV–HIV co-infected patients and their association with treatment outcomes is available especially from India. Hence, the present study aimed to study naturally occurring RAS among non-cirrhotic HCV–HIV co-infected patients and their impact on the response to anti-HCV therapy. Patients and Methods In this retrospective study, archived blood samples of 80 HCV–HIV co-infected patients, before anti-HCV therapy initiation, were tested for substitutions at the drug acting sites (NS5a and NS5b) in the HCV genome by direct PCR sequencing. Results BL-RAS were seen in 19 (23.7%) patients. As well as BL-RAS, all patients were given sofosbuvir (SOF) 400 mg+ daclatasvir (DCV) 60 mg for 12 weeks. Overall, sustained virological response (SVR) was achieved in 63 (78.8%) patients, in 13 with BL-RAS and in 50 without BL-RAS. All the SVR failure cases (n=17) were retreated with SOF (400 mg) +DCV (60 mg)+ ribavirin (RBV) for 24 weeks. SVR was eventually attained in 14 (82.3%) patients, in 4/6 (66.6%) with BL-RAS and in 10/11 (91%) without BL-RAS. On univariate analysis, age more than 30 years (OR: 11.6; 95% CI: 3.0–45.5, p-value<0.001) and female gender (OR: 8.6; 95% CI: 1.1−69, p-value <0.009) were found to be significant factors associated with the attainment of SVR. Conclusion BL-RAS are common in HCV–HIV co-infected patients. The existence of BL-RAS, however, did not affect the attainment of SVR among non-cirrhotic, treatment naive HCV–HIV co-infected patients.

Treatment Response and Drug Resistance Profiling of Genotype 6 of Hepatitis C Virus in HCV/HIV Co-Infected Patients: A Pilot Study from INDIA

“…We examined the sequences of HCV GT6 for the presence of RAS as per our previously published protocol [ 12 ]. None of the viral variants carried any naturally occurring RASs in their NS5b region, whereas two samples carried mutation at the NS5a region (one patient with T93A and another one with T93S).…”

“…30% of the HCV sequences, isolated from CHC patients, belong to GT6, second to GT3 [ 16 ]. A previous study from our group has reported HCV GT6 as the dominant GT in HCV/HIV co-infected cohort, [ 12 ]. Detailed information on HCV genotyping and sub-genotyping and its geographical mapping could contribute immensely to the effective elimination of HCV from our country and faster achievement of the global goal of HCV elimination by 2030.…”