Abstract
There have been a few reports on the treatment of patients infected with recombinant hepatitis C virus (HCV) genotype 2/1 strains with direct-acting antivirals (DAAs). We experienced three patients, with genotype 2/1 recombinant HCV, treated with DAAs successfully. The first, a 39-year-old man, was infected with recombinant HCV genotype 2a/1b, a rare variant. The sequence of the relapsed virus showed chimeric HCV 2a/1b with the recombinant breakpoint found at nucleotide +49 from the start of the NS3 region. Sofosbuvir plus ribavirin, a regimen recommended for HCV genotype 2, did not lead to a sustained viral response (SVR). Retreatment with grazoprevir plus elbasvir resulted in an SVR. The second case, a 70-year-old woman, was infected with recombinant HCV genotype 2b/1b. DAA therapy with sofosbuvir plus ledipasvir resulted in an SVR. The third case, a 48-year-old woman, was also infected with recombinant HCV genotype 2b/1b. DAA therapy with daclatasvir plus asunaprevir resulted in an SVR. The baseline sequences of the viruses from both the second and third cases showed chimeric HCV 2b/1b with the recombinant breakpoint found at nucleotide +10 from the NS3 start. We report three cases with 2/1 chimeras and discuss the prevalence and response to therapy.
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Acknowledgements
This research was supported in part by an Osaka City University Strategic Research Grant in 2017 for basic research (A.T.).
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Dr. H Kumada has received lecture fees from AbbVie Inc., Bristol-Myers Squibb, Gilead Sciences, and MSD K.K. Dr. N Kawada has received lecture fees from Gilead Sciences, and MSD K.K. Dr. A Tamori has received a lecture fee from Gilead Sciences. Other authors declare that they have no conflict of interest.
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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Informed consent was obtained from all patients for being included in the study.
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Okada, M., Hai, H., Tamori, A. et al. Successful direct-acting antiviral treatment of three patients with genotype 2/1 recombinant hepatitis C virus. Clin J Gastroenterol 12, 213–217 (2019). https://doi.org/10.1007/s12328-018-0922-9
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DOI: https://doi.org/10.1007/s12328-018-0922-9