Aranday-Cortes, E. et al. (2022) Real-world outcomes of direct-acting antiviral treatment and retreatment in United Kingdom–based patients infected with hepatitis C virus genotypes/subtypes endemic in Africa. Journal of Infectious Diseases, 226(6), pp. 995-1004. (doi: 10.1093/infdis/jiab110) (PMID:33668068) (PMCID:PMC9492310)
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Abstract
Background: Chronic HCV infection affects 71 million individuals, mostly residing in low- and middle-income countries (LMICs). Direct-acting antivirals (DAA) give high rates of sustained virological response (SVR) in high income countries where a restricted range of HCV genotypes/subtypes circulate. Approach: We studied UK-resident patients born in Africa to examine DAA effectiveness in LMICs where there is far greater breadth of HCV genotypes/subtypes. Viral genome sequences were determined from 233 patients. Results: Full-length viral genomic sequences for 26 known subtypes and 5 previously unidentified isolates covering 5 HCV genotypes were determined. From 149 patients who received DAA treatment/retreatment, the overall SVR was 93%. Treatment failure was associated primarily with two subtypes, gt1l and gt4r, using Sofosbuvir/Ledipasvir. These subtypes contain natural resistance-associated variants that likely contribute to poor efficacy with this drug combination. Treatment failure was also significantly associated with hepatocellular carcinoma. Conclusions: DAA combinations give high SVR rates despite the high HCV diversity across the African continent except for subtypes gt1l and gt4r, which respond poorly to Sofosbuvir/Ledipasvir. These subtypes are widely distributed across Western, Central and Eastern Africa. Thus, in circumstances where accurate genotyping is absent, Ledipasvir and its generic compounds should not be considered as a recommended treatment option.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was funded by the UK Medical Research Council (MC_UU_12014/1). HCV Research UK received support from the Medical Research Foundation (C0365). ECT was also funded by the Wellcome Trust (102789/Z/13/A). KA (Adeboyejo) was supported by the Tertiary Education Trust Fund (TETFUND) and the NIHR Nottingham Biomedical Research Centre. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Thomson, Professor Emma and Aranday-Cortes, Dr Elihu and Tong, Dr Lily and Vattipally, Dr Sreenu and Da Silva Filipe, Dr Ana and Davis, Dr Chris and McLauchlan, Professor John |
| Authors: | Aranday-Cortes, E., McClure, C. P., Davis, C., Irving, W. L., Adeboyejo, K., Tong, L., da Silva Filipe, A., Sreenu, V., Agarwal, K., Mutimer, D., Stone, B., Cramp, M. E., Thomson, E. C., Ball, J. K., and McLauchlan, J. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research |
| Journal Name: | Journal of Infectious Diseases |
| Publisher: | Oxford University Press |
| ISSN: | 0022-1899 |
| ISSN (Online): | 1537-6613 |
| Published Online: | 01 March 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published in Journal of Infectious Diseases 226(6): 995-1004 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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