Successful direct-acting antiviral treatment of three patients with genotype 2/1 recombinant hepatitis C virus
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.
KeywordsChimeric HCV Direct-acting antivirals HCV genotype 2/1
This research was supported in part by an Osaka City University Strategic Research Grant in 2017 for basic research (A.T.).
Compliance with ethical standards
Conflict of interest
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.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients for being included in the study.
- 13.Tatsuya Aikawa F, Tsuda C, Ueno, et al. Comparison of test results of serogrouping and core region PCR-based genotyping in patients with chronic hepatitis C virus infection: Analysis of inderminate or discrepant cases and identification of a 2b/1b recombinant HCV. Kanzo. 2016;57:447–56. (in Japanese).CrossRefGoogle Scholar
- 14.Kurata H, Uchida Y, Kouyama JI, et al. Chronic hepatitis caused by hepatitis C virus showing a discrepancy between serogroup and genotype because of intergenotypic 2b/1b recombination: A pitfall in antiviral therapy with direct-acting antivirals. Hepatol Res. 2018. https://doi.org/10.1111/hepr.12977.CrossRefPubMedGoogle Scholar