Genetic diversity of hepatitis C virus and the prevalence of resistance mutations to NS5A inhibitors in the Krasnoyarsk region

V. E. Ekushov, A. V. Totmenin, L. G. Gotfrid, M. R. Halikov, V.-V. V. Minikhanova, S. Skudarnov, T. S. Ostapova, N. M. Gashnikova
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Abstract

To research the molecular genetic characteristics of the HCV population circulating among HIV‐infected residents of the Krasnoyarsk Territory, including analysis of resistance‐associated mutations to NS5A inhibitors. Total RNA was isolated from 94 blood plasma samples from HIV/HCVinfected residents of the region and the nucleotide sequences of the Core/E1 gene and NS5A gene regions were obtained and deciphered, which were used for genotyping and searching for resistance mutations.In the HCV samples studied, the circulation of five virus subtypes was recorded: 1b (47,9 %), 3a (37,2 %), 1a (10,6 %), 2a (3,2 %) and 2k (1,1 %). Phylogenetic analysis of HCVs revealed partial clustering within subtypes 1a and 3a on a territorial basis. HCV subtypes 1b, 2a and 2k were grouped with other HCVs previously isolated in Russia, Armenia and Kyrgyzstan. Among the HCVs studied, no clusters were found that were common to HIV‐infected individuals with the same route of infection. Among patients who had no experience of taking DAAs, HCV resistance mutations in the NS5A region were found in 42,3 % of cases for those infected with subtype 3a virus and in 75,6 % of cases for those infected with HCV subtype 1b.The analysis of the diversity and occurrence of mutations of HCV drug resistance to direct antiviral drugs is extremely important for the development of tactics for effective treatment of CHC. The high prevalence of polymorphic mutations that affect sensitivity to DAAs indicates the relevance of introducing HCV resistance analysis into clinical practice.
克拉斯诺亚尔斯克地区丙型肝炎病毒的遗传多样性和对 NS5A 抑制剂的抗药性变异的流行情况
研究在克拉斯诺亚尔斯克边疆区感染艾滋病毒的居民中循环的 HCV 群体的分子遗传特征,包括分析对 NS5A 抑制剂的耐药性相关突变。从该地区 94 名感染艾滋病毒/HCV 的居民血浆样本中分离出了总 RNA,并获得和破译了核心/E1 基因和 NS5A 基因区域的核苷酸序列,这些序列被用于基因分型和搜索耐药性突变。在所研究的 HCV 样本中,记录了五种病毒亚型的循环:1b(47.9%)、3a(37.2%)、1a(10.6%)、2a(3.2%)和 2k(1.1%)。HCV 的系统发育分析表明,1a 和 3a 亚型在地域基础上有部分聚类。HCV亚型1b、2a和2k与之前在俄罗斯、亚美尼亚和吉尔吉斯斯坦分离到的其他HCV归为一类。在所研究的丙型肝炎病毒中,没有发现与艾滋病毒感染者具有相同感染途径的病毒群。在没有服用过DAAs的患者中,感染3a亚型病毒的患者中有42.3%的病例发现了NS5A区域的HCV耐药性突变,感染1b亚型HCV的患者中有75.6%的病例发现了这种突变。影响对DAAs敏感性的多态突变的高发生率表明,将HCV耐药性分析引入临床实践具有重要意义。
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