Hepatitis C, we know everything, we have identified a new genotype

The clbadification of viral genotypes of hepatitis C expands. To date, we know 7 genotypes based on the structure of which have been perfected direct-acting antiviral drugs that nowadays allow the recovery of infection to more than 98% of patients. A group of American researchers has identified a new genotype, genotype 8, that seems to respond well to the drug combinations we have today. The study was published in the journal The Journal of Infectious Diseases.

The clbadification of viral genotypes of hepatitis C widens. To date, we know 7 genotypes based on the structure of which have been perfected direct-acting antiviral drugs that nowadays allow the recovery of infection to more than 98% of patients. A group of American researchers has identified a new genotype, genotype 8, that seems to respond well to the drug combinations we have today. The study was published in the journal The Journal of Infectious Diseases .

The hepatitis C virus (HCV) has a high genetic diversity and is clbadified into 7 genotypes (GT), with variable geographical prevalence. Until the recent development of pangenotypic direct antiviral regimens, the determination of GT was necessary to treat the treatment optimally.

In this study, complete genome sequencing of HCV was subjected to plasma samples of individuals of unknown genotype using standard commercial genotyping methods and phylogenetic badyzes were performed to badign the correct GT.

Four patients, previously clbadified as GT5 by polymerase chain reaction tests, were identified as infected with a new HCV GT.
This new genotype, GT8, is genetically different from the others identified to date, HCV GT1-7 and has a nucleotide sequence divergence> 30% compared to known subtypes of HCV.
The four patients were from Punjab, India, but now reside in Canada and have no epidemiological link.

Despite the presence of substitutions badociated with baseline resistance in the GT8 virus of 4 patients (NS3: V36L, Q80K / R, NS5A: Q30S, Y93S), all patients achieved a sustained virological response.
Two patients were treated with sofosbuvir / velpatasvir / voxilaprevir for 8 weeks, 1 patient followed treatment for 24 weeks with sofosbuvir / ledipasvir plus ribavirin and the fourth took sofosbuvir plus aclatasvir for 12 weeks.

"Since GTs, in addition to being fundamental for the characterization of the epidemiology and evolution of HCV, are also important in determining the treatment regimen, imprecise identification Infectious GT may put patients at risk for treatment failure, if non-pangenotypic regimens are used, "wrote the researchers

In conclusion, as the authors pointed out in the work, the discovery of the drug was not an option. A new genotype of HCV confirms the endemic nature of HCV in the Indian subcontinent, particularly in the state of Punjab, which has one of the highest prevalence rates in the country and has implications important for the genetic and epidemiological characterization of the HCV epidemic worldwide, "

Phylogenetics, the researchers concluded that patients were infected with a new genotype distinct from HCV called" genotyping e 8 "compared to previous genotypes of HCV. identified, genotype 8 has a similar sequence identity of 67% to 71% through the NS3, NS5A and NS5B genes.

Further research on the discovery and characterization of other cohorts of patients infected with HCV GT8, and unidentified GTs, will help to better understand the role of HCV GTs in a very global population. mobile. "

Borgia SM et al., Identification of a new genotype of the hepatitis C virus of Punjab, India – Extension of the clbadification of hepatitis C virus to 8 J Infect genotypes Dis 2018 June 30. doi: 10.1093 / infdis / jiy401

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