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Shah R, Barclay ST, Peters ES, Fox R, Gunson R, Bradley-Stewart A, Shepherd SJ, MacLean A, Tong L, van Vliet VJE, Ngan Chiu Bong M, Filipe A, Thomson EC, Davis C. Characterisation of a Hepatitis C Virus Subtype 2a Cluster in Scottish PWID with a Suboptimal Response to Glecaprevir/Pibrentasvir Treatment. Viruses 2022; 14:v14081678. [PMID: 36016300 PMCID: PMC9416734 DOI: 10.3390/v14081678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Direct-acting antivirals (DAAs) have revolutionised the treatment of Hepatitis C virus (HCV), allowing the World Health Organisation (WHO) to set a target of eliminating HCV by 2030. In this study we aimed to investigate glecaprevir and pibrentasvir (GP) treatment outcomes in a cohort of patients with genotype 2a infection. METHODS Clinical data and plasma samples were collected in NHS Greater Glasgow & Clyde. Next generation whole genome sequencing and replicon assays were carried out at the MRC-University of Glasgow Centre for Virus Research. RESULTS 132 cases infected with genotype 2a HCV were identified. The SVR rate for this group was 91% (112/123) following treatment with GP. An NS5A polymorphism, L31M, was detected in all cases of g2a infection, and L31M+R353K in individuals that failed treatment. The results showed that R353K was present in 90% of individuals in the Glasgow genotype 2a phylogenetic cluster but in less than 5% of all HCV subtype 2a published sequences. In vitro efficacy of pibrentasvir against sub-genomic replicon constructs containing these mutations showed a 2-fold increase in IC50 compared to wildtype. CONCLUSION This study describes a cluster of HCV genotype 2a infection associated with a lower-than-expected SVR rate following GP treatment in association with the NS5A mutations L31M+R353K.
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Affiliation(s)
- Rajiv Shah
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
- Correspondence: (R.S.); (C.D.)
| | - Stephen T. Barclay
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Erica S. Peters
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Ray Fox
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Rory Gunson
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Amanda Bradley-Stewart
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Samantha J. Shepherd
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Alasdair MacLean
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Lily Tong
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
| | - Vera Jannie Elisabeth van Vliet
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
| | - Michael Ngan Chiu Bong
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
| | - Ana Filipe
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
| | - Emma C. Thomson
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
- NHS Greater Glasgow & Clyde, Departments of Hepatology and Virology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK; (S.T.B.); (E.S.P.); (R.F.); (A.B.-S.); (S.J.S.); (A.M.)
| | - Chris Davis
- Thomson Group, College of Medical, Veterinary & Life Sciences, MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK; (R.G.); (L.T.); (V.J.E.v.V.); (M.N.C.B.); (A.F.); (E.C.T.)
- Correspondence: (R.S.); (C.D.)
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