Prevalence of naturally occurring amino acid substitutions associated with resistance to hepatitis C virus NS3/NS4A protease inhibitors in São Paulo state

Arch Virol. 2018 Oct;163(10):2757-2764. doi: 10.1007/s00705-018-3920-9. Epub 2018 Jun 30.

Abstract

Hepatitis C (HCV)-infected patients are treated with direct-acting antiviral agents (DAAs) in highly effective, well-tolerated, all-oral regimens. However, naturally occurring resistance-associated amino acid substitutions (RASs) may be selected during treatment. This study aimed to screen naturally occurring RASs NS3/NS4A inhibitors (PIs). Samples were obtained from DAA naïve patients, living in São Paulo state, Brazil. Screening for RASs in the HCV NS3 region was conducted in 859 samples from HCV-infected patients, of which 425 and 434 samples were subtype 1a and 1b, respectively. HCV-RNA was extracted, amplified, and sequenced. The overall prevalence of RASs to HCV PIs was 9.4%. The following RASs were observed in HCV-1a subtype infected patients: V36L (2.6%), T54S (1.6%), V55I/A (1.2% / 8.9%, respectively), Q80K (2.1%), R155K (0.5%), and D168E (0.2%); and in HCV-1b infected patients: V36L (0.7%), T54A/S (0.2% and 0.5%, respectively), V55A (0.5%), Q80K (0.2%), D168E (1.6%), and M175L (0.5%). HCV 1a infected subjects had higher serum viral load than that seen in patients infected with HCV 1b. There was no difference between the proportions of NS3 RASs with regards to geographic distribution within the investigated areas. These findings should be supported by additional studies in Brazil to help in the formation of local clinical guidelines for managing hepatitis C.

MeSH terms

  • Adult
  • Amino Acid Substitution
  • Antiviral Agents / administration & dosage*
  • Brazil / epidemiology
  • Carrier Proteins / antagonists & inhibitors*
  • Carrier Proteins / metabolism
  • Drug Resistance, Viral*
  • Female
  • Genotype
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics*
  • Hepacivirus / isolation & purification
  • Hepacivirus / metabolism
  • Hepatitis C / drug therapy*
  • Hepatitis C / epidemiology
  • Hepatitis C / virology
  • Humans
  • Intracellular Signaling Peptides and Proteins
  • Male
  • Middle Aged
  • Mutation, Missense / drug effects
  • Prevalence
  • Protease Inhibitors / administration & dosage*
  • Viral Nonstructural Proteins / antagonists & inhibitors*
  • Viral Nonstructural Proteins / metabolism
  • Young Adult

Substances

  • Antiviral Agents
  • Carrier Proteins
  • Intracellular Signaling Peptides and Proteins
  • NS3 protein, hepatitis C virus
  • NS4A cofactor peptide, Hepatitis C virus
  • Protease Inhibitors
  • Viral Nonstructural Proteins