Archives of Virology

, Volume 158, Issue 9, pp 1907–1915 | Cite as

Analysis of sequences of hepatitis C virus NS5A genotype 1 in HIV-coinfected patients with a null response to nitazoxanide or peg-interferon plus ribavirin

  • M. Sede
  • N. Laufer
  • D. Ojeda
  • A. Gun
  • P. Cahn
  • J. QuarleriEmail author
Original Article


Even though new drugs have been approved for treatment of hepatitis C virus (HCV) infection, the risk of drug-drug interactions and concern about overlapping toxicities has hindered the development of studies in HIV/HCV-coinfected individuals. Traditional treatment with pegylated interferon plus ribavirin (peg-IFN + RBV) is very expensive and has a low rate of sustained virological response in coinfected patients, especially if they are infected with HCV genotype 1. Nitazoxanide (NTZ) is a drug that is being evaluated for the treatment of chronic HCV infection, both in HCV-monoinfected and HIV/HCV-coinfected patients. Understanding the NTZ resistance mechanism could allow the development of resistance to be minimized and would expand the treatment options, mainly in special populations such as HIV/HCV-coinfected patients. Similarly to IFN, NTZ increases the activity of the cellular protein kinase activated by double-stranded RNA (PKR), a key kinase in the innate antiviral response. In order to elucidate whether sequence heterogeneity in the PKR-binding domain of HCV NS5A genotype 1 could influence the antiviral activity of either NTZ monotherapy or peg-IFN + RBV, baseline and end-of-therapy plasma samples from two groups of eleven non-responder HIV/HCV-coinfected patients that had received NTZ or peg-IFN + RBV were studied. Most of the HCV NS5A sequences examined at the end of therapy did not change from the baseline, even after 30 days course of antiviral therapy. An extensive comparison of HCV NS5A genotype 1 and 4 sequences from the database with reported IFN therapy outcome was performed in order to infer their phylogenetic relationships. The HCV genotype 1 NS5A nucleotide sequences from therapy-non-responder patients were intermingled amongst those from the database, irrespective of their IFN-therapy outcome. When comparing NS5A-PKRBD amino acid sequences, significant differences were observed in genotype 4, but not in genotype 1 (p < 0.0001 and p > 0.05, respectively). In conclusion, despite IFN and NTZ sharing the protein kinase activated by double-stranded RNA as their cellular target, the HCV genotype 1 strategy to counteract the IFN action mediated by NS5A ISDR/PKRBD does not explain drug resistance in HIV/HCV-coinfected patients. Other viral factors that are possibly involved are discussed as well.


Sustained Virological Response Nitazoxanide NS5A Sequence Sustained Virological Responder NS5A Amino Acid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported partially by grants from the University of Buenos Aires (SECYT-UBA 2012-2015), and the Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET-PIP112 200801 01773).


The authors have no conflict(s) of interest.


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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • M. Sede
    • 1
    • 2
  • N. Laufer
    • 1
    • 2
    • 3
  • D. Ojeda
    • 1
    • 2
  • A. Gun
    • 4
  • P. Cahn
    • 3
    • 4
  • J. Quarleri
    • 1
    • 2
    Email author
  1. 1.Instituto de Investigaciones Biomédicas en Retrovirus y Sida, Facultad de MedicinaUniversidad de Buenos AiresBuenos AiresArgentina
  2. 2.CONICETBuenos AiresmArgentina
  3. 3.División InfectologíaHospital Juan Fernández, CABABuenos AiresArgentina
  4. 4.Fundación HuéspedBuenos AiresArgentina

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