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Advanced Sequencing Detected Infection in Patients with HIV/HCV After Therapy

Next-generation sequencing revealed persisting strains of infection in men who have sex with men coinfected with HIV and hepatitis C virus who underwent standard therapy, according to new study data.

Researchers studied 99 patients coinfected with hepatitis C virus and HIV and treated with pegylated interferon-alfa and ribavirin for 24 to 48 weeks. Fifteen of the patients did not achieve sustained virologic response (SVR); six were null responders, three were partial responders, and six relapsed. The investigators used Sanger and 454 pyrosequencing methods to analyze pre- and posttreatment paired HCV quasispecies to determine if reinfection or pre-existing infection caused SVR failure.

By using direct sequencing, 10 of the patients who failed to achieve SVR showed evidence of a strain of previously undetected infection after therapy. Pyrosequencing, however, showed that all 15 patients had persistent infection. Six had evidence of a variant in the posttreatment sample that was previously undetected at baseline and another variant detectable at baseline.

“Deep sequencing technologies are a powerful tool for obtaining a more accurate insight into the dynamics of variants in the HCV quasispecies in human samples,” the researchers wrote. “The detection of multiple genotypes that have the potential to emerge following treatment may also have implications in the new era of [direct-acting antiviral agents] when the presence of multiple genotypes and low-level resistance mutations may impact on treatment success.”

Disclosure: The researchers report no relevant financial disclosures.