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Ye J, Sun Y, Li J, Lu X, Zheng M, Liu L, Yu F, He S, Xu C, Ren X, Wang J, Chen J, Ruan Y, Feng Y, Shao Y, Xing H, Lu H. Distribution pattern, molecular transmission networks, and phylodynamic of hepatitis C virus in China. PLoS One 2023; 18:e0296053. [PMID: 38128044 PMCID: PMC10734925 DOI: 10.1371/journal.pone.0296053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
In China, few molecular epidemiological data on hepatitis C virus (HCV) are available and all previous studies were limited by small sample sizes or specific population characteristics. Here, we report characterization of the epidemic history and transmission dynamics of HCV strains in China. We included HCV sequences of individuals belonging to three HCV surveillance programs: 1) patients diagnosed with HIV infection at the Beijing HIV laboratory network, most of whom were people who inject drugs and former paid blood donors, 2) men who have sex with men, and 3) the general population. We also used publicly available HCV sequences sampled in China in our study. In total, we obtained 1,603 Ns5b and 865 C/E2 sequences from 1,811 individuals. The most common HCV strains were subtypes 1b (29.1%), 3b (25.5%) and 3a (15.1%). In transmission network analysis, factors independently associated with clustering included the region (OR: 0.37, 95% CI: 0.19-0.71), infection subtype (OR: 0.23, 95% CI: 0.1-0.52), and sampling period (OR: 0.43, 95% CI: 0.27-0.68). The history of the major HCV subtypes was complex, which coincided with some important sociomedical events in China. Of note, five of eight HCV subtype (1a, 1b, 2a, 3a, and 3b), which constituted 81.8% HCV strains genotyped in our study, showed a tendency towards decline in the effective population size during the past decade until present, which is a good omen for the goal of eliminating HCV by 2030 in China.
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Affiliation(s)
- Jingrong Ye
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Yanming Sun
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Jia Li
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Xinli Lu
- Institute for HIV/AIDS and STD Prevention and Control, Hebei CDC, Shijiazhuang, Hebei, China
| | - Minna Zheng
- Institute for HIV/AIDS and STD Prevention and Control, Tianjin CDC, Hedong District, Tianjin, China
| | - Lifeng Liu
- Center for Infectious Diseases, Beijing YouAn Hospital, Capital Medical University, Feng Tai District, Beijing, China
| | - Fengting Yu
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Shufang He
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Conghui Xu
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Xianlong Ren
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Juan Wang
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Jing Chen
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
| | - Yuhua Ruan
- Division of Virology and Immunology, State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Center for AIDS/STD Prevention and Control (NCAIDS), China CDC, Changping District, Beijing, China
| | - Yi Feng
- Division of Virology and Immunology, State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Center for AIDS/STD Prevention and Control (NCAIDS), China CDC, Changping District, Beijing, China
| | - Yiming Shao
- Division of Virology and Immunology, State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Center for AIDS/STD Prevention and Control (NCAIDS), China CDC, Changping District, Beijing, China
| | - Hui Xing
- Division of Virology and Immunology, State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Center for AIDS/STD Prevention and Control (NCAIDS), China CDC, Changping District, Beijing, China
| | - Hongyan Lu
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Dong Chen District, Beijing, China
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Nhu QBT, Thuy LLT, Nguyen HT, Thanh BN, Rapoud D, Quillet C, Tran HT, Vallo R, Tuyet TNT, Michel L, Weiss L, Perre PV, Hai VV, Nagot N, Hai OKT, Des Jarlais D, Duong HT, Minh KP, Laureillard D, Molès JP. HCV RNA Quantification by a Domestic Commercial Assay: A Case Study among People Who Inject Drugs in Vietnam. Diagnostics (Basel) 2023; 13:3456. [PMID: 37998592 PMCID: PMC10670863 DOI: 10.3390/diagnostics13223456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The desired performance of nucleic acid testing (NAT) may vary if used for disease diagnosis or for the evaluation of the therapeutic efficacy of a treatment, although in most cases, the same assay is used. However, these tests may not be affordable in many situations including in low/middle income countries that in response have developed domestic assays. Given the example of HCV NAT among people who inject drugs in Vietnam, we aimed at evaluating a domestic assay versus an FDA- and CE-approved assay. This cross-evaluation revealed that (i) the domestic assay had a poorer sensitivity with a threshold of detection above 104 IU/mL, and (ii) the FDA-approved assay had a percentage of false negative results close to 1%. Together, in the present study, the domestic assay had a performance compatible with diagnosis purposes (given that this population was 70% HCV seropositive) but not compatible with HCV treatment monitoring (given that treatment failures are rare and the observed viremia frequently below the threshold of detection). This study highlights the need for a proper evaluation of HCV RNA domestic assays in order to efficiently contribute to the WHO HCV elimination target by 2030.
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Affiliation(s)
- Quynh Bach Thi Nhu
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Linh Le Thi Thuy
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Hong Thi Nguyen
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Binh Nguyen Thanh
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Delphine Rapoud
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
| | - Catherine Quillet
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
| | - Hong Thi Tran
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Roselyne Vallo
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
| | - Thanh Nham Thi Tuyet
- Supporting Community Development Initiatives, Hanoi 111000, Vietnam; (T.N.T.T.); (O.K.T.H.)
| | - Laurent Michel
- Inserm UMRS 1018, Pierre Nicole Center, French Red Cross, 75005 Paris, France;
| | - Laurence Weiss
- Université Paris Descartes, Sorbonne Paris Cité, Inserm U976, 75006 Paris, France;
| | - Philippe Vande Perre
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
| | - Vinh Vu Hai
- Infectious and Tropical Diseases Department, Viet Tiep Hospital, Hai Phong 180000, Vietnam;
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
| | - Oanh Khuat Thi Hai
- Supporting Community Development Initiatives, Hanoi 111000, Vietnam; (T.N.T.T.); (O.K.T.H.)
| | - Don Des Jarlais
- School of Global Public Health, New York University, New York, NY 10012, USA;
| | - Huong Thi Duong
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Khue Pham Minh
- Public Health Faculty, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam; (Q.B.T.N.); (L.L.T.T.); (H.T.N.); (B.N.T.); (H.T.T.); (H.T.D.); (K.P.M.)
| | - Didier Laureillard
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
- Infectious Diseases Department, Caremeau University Hospital, 30900 Nîmes, France
| | - Jean-Pierre Molès
- Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Inserm, 34394 Montpellier, France; (D.R.); (C.Q.); (R.V.); (P.V.P.); (N.N.); (D.L.)
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Flower B, Hung LM, Mccabe L, Ansari MA, Le Ngoc C, Vo Thi T, Vu Thi Kim H, Nguyen Thi Ngoc P, Phuong LT, Quang VM, Dang Trong T, Le Thi T, Nguyen Bao T, Kingsley C, Smith D, Hoglund RM, Tarning J, Kestelyn E, Pett SL, van Doorn R, Van Nuil JI, Turner H, Thwaites GE, Barnes E, Rahman M, Walker AS, Day JN, Chau NVV, Cooke GS. Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for hepatitis C in a single-arm mechanistic pilot study. eLife 2023; 12:e81801. [PMID: 36622106 PMCID: PMC9870305 DOI: 10.7554/elife.81801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/23/2022] [Indexed: 01/10/2023] Open
Abstract
Background World Health Organization has called for research into predictive factors for selecting persons who could be successfully treated with shorter durations of direct-acting antiviral (DAA) therapy for hepatitis C. We evaluated early virological response as a means of shortening treatment and explored host, viral and pharmacokinetic contributors to treatment outcome. Methods Duration of sofosbuvir and daclatasvir (SOF/DCV) was determined according to day 2 (D2) virologic response for HCV genotype (gt) 1- or 6-infected adults in Vietnam with mild liver disease. Participants received 4- or 8-week treatment according to whether D2 HCV RNA was above or below 500 IU/ml (standard duration is 12 weeks). Primary endpoint was sustained virological response (SVR12). Those failing therapy were retreated with 12 weeks SOF/DCV. Host IFNL4 genotype and viral sequencing was performed at baseline, with repeat viral sequencing if virological rebound was observed. Levels of SOF, its inactive metabolite GS-331007 and DCV were measured on days 0 and 28. Results Of 52 adults enrolled, 34 received 4 weeks SOF/DCV, 17 got 8 weeks and 1 withdrew. SVR12 was achieved in 21/34 (62%) treated for 4 weeks, and 17/17 (100%) treated for 8 weeks. Overall, 38/51 (75%) were cured with first-line treatment (mean duration 37 days). Despite a high prevalence of putative NS5A-inhibitor resistance-associated substitutions (RASs), all first-line treatment failures cured after retreatment (13/13). We found no evidence treatment failure was associated with host IFNL4 genotype, viral subtype, baseline RAS, SOF or DCV levels. Conclusions Shortened SOF/DCV therapy, with retreatment if needed, reduces DAA use in patients with mild liver disease, while maintaining high cure rates. D2 virologic response alone does not adequately predict SVR12 with 4-week treatment. Funding Funded by the Medical Research Council (Grant MR/P025064/1) and The Global Challenges Research 70 Fund (Wellcome Trust Grant 206/296/Z/17/Z).
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Affiliation(s)
- Barnaby Flower
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
| | - Le Manh Hung
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | - Leanne Mccabe
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
| | - M Azim Ansari
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Chau Le Ngoc
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Thu Vo Thi
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Hang Vu Thi Kim
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | | | | | - Vo Minh Quang
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | | | - Thao Le Thi
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Tran Nguyen Bao
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Cherry Kingsley
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
| | - David Smith
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Richard M Hoglund
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Faculty of Tropical MedicineBangkokThailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Joel Tarning
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Faculty of Tropical MedicineBangkokThailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Evelyne Kestelyn
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Sarah L Pett
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
| | - Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
- Oxford University Clinical Research UnitHanoiVietnam
| | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Hugo Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Guy E Thwaites
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Ann Sarah Walker
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
- Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
- The National Institute for Health Research, Oxford Biomedical Research Centre, University of OxfordOxfordUnited Kingdom
| | - Jeremy N Day
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | | | - Graham S Cooke
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
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Kwan TH, Wong BCK, Wong KH, Lee SS. Hepatitis C Co-infection in People Living With HIV—Epidemiologic Differences Between Men Who Have Sex With Men MSM and Non-MSM. Front Public Health 2022; 10:925600. [PMID: 35719672 PMCID: PMC9204175 DOI: 10.3389/fpubh.2022.925600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
People living with human immunodeficiency virus (PLHIV) constitute a unique group at higher risk of hepatitis C virus (HCV) co-infection. In light of the diverse profiles of PLHIV, we differentiated between men who have sex with men (MSM) and non-MSM in the characterization of the epidemiologic features of HIV/HCV co-infection. Clinical data of HCV co-infection patients from the HIV specialist clinic in Hong Kong were retrospectively collected in conjunction with their HIV subtypes and HCV genotypes. Logistic regression models were used to identify factors associated with HIV/HCV co-infection in MSM. Survival analysis was performed to compare the time lag between HIV and HCV diagnoses between two groups. Latent class analysis was conducted to describe the features of different classes of co-infections. Four classes of HIV/HCV co-infections were identified: local MSM acquiring HCV after HIV diagnosis, local MSM with HIV/HCV co-diagnoses, local non-MSM, and non-local non-MSM. Accounting for over half of the co-infections, MSM were more likely to be younger, local residents, and associated with HCV genotype 3, compared to genotypes 1 and 6 in non-MSM. Overall, MSM had higher odds of achieving HIV viral suppression and co-diagnosing with a sexually transmitted infection at HCV diagnosis, and having a longer time lag between HIV and HCV diagnoses. Drug injection accounted for a majority of non-MSM HCV infection. There were distinctive epidemiologic differences between MSM and non-MSM co-infected with HIV and HCV, the characteristics of which could inform intervention strategies for achieving HCV micro-elimination.
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Safarnezhad Tameshkel F, Karbalaie Niya MH, Khoonsari M, Ajdarkosh H, Faraji AH, Nikkhah M, Motamed N, Azarkeivan A, Gholami A, Sohrabi MR, Keyvani H, Zamani F. Effect of Baseline Resistance-Associated Substitutions on Thalassemia Patients with Chronic HCV Infection: A Two-Year Follow-Up. Middle East J Dig Dis 2021; 13:27-34. [PMID: 34712435 PMCID: PMC8531936 DOI: 10.34172/mejdd.2021.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/16/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection showed the presence of resistant-associated substitutions (RASs). The aim of the present study was to carry out a follow-up of patients with baseline RASs to report the impact of RASs on DAA therapy outcome. METHODS In a cohort study, we analyzed NS5A and NS5B RASs among nine thalassemia cases by baseline RASs. In a 2-year follow-up, we analyzed viral markers and biochemical and hematological parameters of the participants and their sustained virologic response (SVR). Statistical analyses were performed using SPSS software version 22. RESULTS RASs for HCV subtype 1a included M28V, L31M, and H58P. For subtype 1b: L28M, R30Q, S24F, and C316N. And for subtype 3a: C316S, and S24F. In patients with cirrhosis (n = 5), ALT (p = 0.001) and AST (p = 0.007) levels were significantly reduced after treatment, and creatinine level slightly increased (p = 0.025). However, no significant data was observed in non-cirrhotic patients following the treatment. CONCLUSION The present study did not show any adverse effects of DAA therapy among patients with thalassemia suffering from chronic HCV infection with baseline RASs. Furthermore, reduction in ferritin and liver stiffness levels after DAA therapy could show the efficacy of DAA in such patients.
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Affiliation(s)
| | - Mohammad Hadi Karbalaie Niya
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoodreza Khoonsari
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Faraji
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nikkhah
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azita Azarkeivan
- Pediatric Hematology Oncology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Thalassemia Clinic, Tehran, Iran
| | - Ali Gholami
- Non-communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.,Department of Epidemiology & Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Masood Reza Sohrabi
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
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Almosa FAM, Alnasser AHA, Al-Tawfiq JA. Distribution of hepatitis C virus (HCV) genotypes in a Saudi Arabian hospital during the 2015-2020 period. LE INFEZIONI IN MEDICINA 2021; 29:450-455. [PMID: 35146350 PMCID: PMC8805486 DOI: 10.53854/liim-2903-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/15/2021] [Indexed: 06/14/2023]
Abstract
Hepatitis C virus (HCV) is the leading cause of chronic liver disease. HCV genotypes and subtypes are important predictors of disease progression and antiviral treatment response. To our knowledge, there had been limited studies of HCV genotypes in Qatif, Saudi Arabia. This study aims to assess the distribution of HCV genotypes in Qatif Central Hospital, Qatif, Saudi Arabia. This is a retrospective study of adult patients with HCV infection between January 2015 and December 2020. Only patients with documented HCV genotyping were included. A total of 356 HCVinfected patients fulfilled the inclusion criteria and were included in further analysis. Of those patients, 179 (50.3%) were males, and most were Saudi (N=347, 97.5%). The median age was 60 years, and 191 (53.7%) were 50-69 years of age. Genotype 2 was present in 118 (33.1%) of the patients, followed by genotype 4 in 92 (25.8%), genotype 1B in 62 (17.4%), and genotype 1A in 37 (10.4%). The study showed that HCV genotype 2 is the predominant variant among chronic HCV patients in the study population. Monitoring the epidemiology of HCV genotypes may provide guidance in treatment decisions.
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Affiliation(s)
- Fadel Ali M. Almosa
- Gastroenterology Unit, Department of Internal Medicine, Qatif Central Hospital, Ministry of Health, Qatif, Saudi Arabia
| | - Ali Hassan A. Alnasser
- Department of Laboratory, Dhahran Eye Specialist Hospital, Ministry of Health, Dhahran, Saudi Arabia
| | - Jaffar A. Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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7
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Flower B, McCabe L, Le Ngoc C, Le Manh H, Le Thanh P, Dang Trong T, Vo Thi T, Vu Thi Kim H, Nguyen Tat T, Phan Thi Hong D, Nguyen Thi Chau A, Dinh Thi T, Tran Thi Tuyet N, Tarning J, Kingsley C, Kestelyn E, Pett SL, Thwaites G, Nguyen Van VC, Smith D, Barnes E, Ansari MA, Turner H, Rahman M, Walker AS, Day J, Cooke GS. High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis With 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study. Open Forum Infect Dis 2021; 8:ofab267. [PMID: 34337093 PMCID: PMC8320300 DOI: 10.1093/ofid/ofab267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Genotype 6 is the most genetically diverse lineage of hepatitis C virus, and it predominates in Vietnam. It can be treated with sofosbuvir with daclatasvir (SOF/DCV), the least expensive treatment combination globally. In regional guidelines, longer treatment durations of SOF/DCV (24 weeks) are recommended for cirrhotic individuals, compared with other pangenotypic regimens (12 weeks), based on sparse data. Early on-treatment virological response may offer means of reducing length and cost of therapy in patients with liver fibrosis. METHODS In this prospective trial in Vietnam, genotype 6-infected adults with advanced liver fibrosis or compensated cirrhosis were treated with SOF/DCV. Day 14 viral load was used to guide duration of therapy: participants with viral load <500 IU/mL at day 14 were treated with 12 weeks of SOF/DCV and those ≥500 IU/mL received 24 weeks. Primary endpoint was sustained virological response (SVR). RESULTS Of 41 individuals with advanced fibrosis or compensated cirrhosis who commenced treatment, 51% had genotype 6a and 34% had 6e. The remainder had 6h, 6k, 6l, or 6o. One hundred percent had viral load <500 IU/mL by day 14, meaning that all received 12 weeks of SOF/DCV. One hundred percent achieved SVR12 despite a high frequency of putative NS5A inhibitor resistance-associated substitutions at baseline. CONCLUSIONS Prescribing 12 weeks of SOF/DCV results in excellent cure rates in this population. These data support the removal of costly genotyping in countries where genotype 3 prevalence is <5%, in keeping with World Health Organization guidelines. NS5A resistance-associated mutations in isolation do not affect efficacy of SOF/DCV therapy. Wider evaluation of response-guided therapy is warranted.
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Affiliation(s)
- Barnaby Flower
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Leanne McCabe
- MRC Clinical Trials Unit at UCL, University College London, United Kingdom
| | - Chau Le Ngoc
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Hung Le Manh
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Thu Vo Thi
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Hang Vu Thi Kim
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Thanh Nguyen Tat
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Dao Phan Thi Hong
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - An Nguyen Thi Chau
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Tan Dinh Thi
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Nga Tran Thi Tuyet
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Joel Tarning
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Cherry Kingsley
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Evelyne Kestelyn
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Sarah L Pett
- MRC Clinical Trials Unit at UCL, University College London, United Kingdom
| | - Guy Thwaites
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | | | | | | | | | - Hugo Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Ann Sarah Walker
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Jeremy Day
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Graham S Cooke
- Department of Infectious Disease, Imperial College London, United Kingdom
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Irekeola AA, Malek NA, Wada Y, Mustaffa N, Muhamad NI, Shueb RH. Prevalence of HCV genotypes and subtypes in Southeast Asia: A systematic review and meta-analysis. PLoS One 2021; 16:e0251673. [PMID: 34014997 PMCID: PMC8136688 DOI: 10.1371/journal.pone.0251673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
Known for its high genetic diversity and variation in genotypic presence in different regions of the world, hepatitis C virus (HCV) is estimated to infect about 71 million people globally. Selection of an appropriate therapeutic regimen largely depends on the identification of the genotype responsible for the infection. This systematic review and meta-analysis was conducted to provide a comprehensive view of HCV genotype and subtype distribution in Southeast Asia (SEA). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We searched five databases without year and language restrictions. Data from 90 eligible studies involving 15,089 genotypes and 9,646 subtypes representing 10 SEA countries were analyzed. The pooled estimates showed that genotype 1 (46.8%) [95% CI, 43.2–50.4; I2 = 92.77%; p < 0.001] was the most dominant HCV genotype in the region, followed by genotype 3 (23.1%) [95% CI, 19.4–27.2; I2 = 93.03%; p < 0.001], genotype 6 (16.5%) [95% CI, 13.8–19.6], genotype 2 (4.6%) [95% CI, 3.5–5.9], genotype 4 (1.1%) [95% CI, 0.7–1.5] and genotype 5 (0.8%) [95% CI, 0.4–1.3]. Philippines had the highest prevalence of genotypes 1 and 2. Genotype 6 became more prevalent after year 2000. Over 40 different subtypes were identified, with subtypes 1b (26.3%), 1a (21.3%), and 3a (14.3%) being the most prevalent of all the reported subtypes. Although on a global scale, genotype 6 is considered highly prevalent in SEA, evidence from this study reveals that it is the third most prevalent genotype within the region.
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Affiliation(s)
- Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
- Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa Kwara State, Nigeria
| | - Nurul Adila Malek
- Department of Pathology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
| | - Yusuf Wada
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
- Department of Zoology, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Nazri Mustaffa
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Nur Izat Muhamad
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Rafidah Hanim Shueb
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- * E-mail:
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9
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Immune system control of hepatitis C virus infection. Curr Opin Virol 2020; 46:36-44. [PMID: 33137689 DOI: 10.1016/j.coviro.2020.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/11/2020] [Indexed: 12/20/2022]
Abstract
Hepatitis C virus (HCV) remains a global public health problem even though more than 95% of infections can be cured by treatment with direct-acting antiviral agents. Resolution of viremia post antiviral therapy does not lead to protective immunity and therefore reinfections can occur. Immune cell detection of HCV activates signaling pathways that produce interferons and trigger the innate immune response against the virus, preventing HCV replication and spread. Cells in the innate immune system, including natural killer, dendritic, and Kupffer cells, interact with infected hepatocytes and present viral antigens to T and B cells where their effector responses contribute to infection outcome. Despite the immune activation, HCV can evade the host response and establish persistent infection. Plans to understand the correlates of protection and strategies to activate proper innate and adaptive immune responses are needed for development of an effective prophylactic vaccine that stimulates protective immunity and limits HCV transmission.
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Due OT, Thakkinstian A, Thavorncharoensap M, Sobhonslidsuk A, Wu O, Phuong NK, Chaikledkaew U. Cost-Utility Analysis of Direct-Acting Antivirals for Treatment of Chronic Hepatitis C Genotype 1 and 6 in Vietnam. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1180-1190. [PMID: 32940236 PMCID: PMC7491253 DOI: 10.1016/j.jval.2020.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/05/2020] [Accepted: 03/23/2020] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Very few cost-utility analyses have either evaluated direct-acting antivirals (DAAs) on hepatitis C virus (HCV) genotype 6 patients or undertaken societal perspective. Recently, DAAs have been introduced into the Vietnamese health insurance drug list for chronic hepatitis C (CHC) treatment without empirical cost-effectiveness evidence. This study was conducted to generate these data on DAAs among CHC patients with genotypes 1 and 6 in Vietnam. METHODS A hybrid decision-tree and Markov model was employed to compare costs and quality-adjusted life-years (QALYs) of available DAAs, including (1) sofosbuvir/ledipasvir, (2) sofosbuvir/velpatasvir, and (3) sofosbuvir plus daclatasvir, with pegylated-interferon plus ribavirin (PR). Primary data collection was conducted in Vietnam to identify costs and utility values. Incremental cost-effectiveness ratios were estimated from societal and payer perspectives. Uncertainty and scenario analyses and value of information analyses were performed. RESULTS All DAAs were cost-saving as compared with PR in CHC patients with genotypes 1 and 6 in Vietnam, and sofosbuvir/velpatasvir was the most cost-saving regimen, from both societal and payer perspectives. From the societal perspective, DAAs were associated with the increment of quality-adjusted life-years by 1.33 to 1.35 and decrement of costs by $6519 to $7246. Uncertainty and scenario analyses confirmed the robustness of base-case results, whereas the value of information analyses suggested the need for further research on relative treatment efficacies among DAA regimens. CONCLUSIONS Allocating resources for DAA treatment for HCV genotype 1 and 6 is surely a rewarding public health investment in Vietnam. It is recommended that the government rapidly scale up treatment and enable financial accessibility for HCV patients.
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Affiliation(s)
- Ong The Due
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; Health Strategy and Policy Institute, Ministry of Health, Hanoi, Vietnam
| | - Ammarin Thakkinstian
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Montarat Thavorncharoensap
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Abhasnee Sobhonslidsuk
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Olivia Wu
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Usa Chaikledkaew
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand; Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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11
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Nguyen DT, Tran TTT, Nghiem NM, Le PT, Vo QM, Day J, Rahman M, Le HM. Effectiveness of sofosbuvir based direct-acting antiviral regimens for chronic hepatitis C virus genotype 6 patients: Real-world experience in Vietnam. PLoS One 2020; 15:e0233446. [PMID: 32433676 PMCID: PMC7239434 DOI: 10.1371/journal.pone.0233446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/05/2020] [Indexed: 12/22/2022] Open
Abstract
Background Hepatitis C virus (HCV) genotype 6 is the commonest cause of chronic hepatitis C infection in much of southeast Asia, but data on the effectiveness of direct-acting antiviral agents (DAAs) against this genotype are limited. We conducted a retrospective cohort study of patients attending the Hospital for Tropical Diseases (HTD), Ho Chi Minh City, Vietnam, to define the effectiveness of DAAs in the treatment of chronic HCV genotype 6 in actual practice. Methods We included all patients with genotype 6 infections attending our hospital between March 2016 and October 2017 who received treatment with sofosbuvir-based DAA treatment regimens, and compared their responses with those with genotype 1 infections. Results 1758 patients (1148 genotype 6, 65.4%; 610 genotype 1, 34.6%) were analyzed. The majority of patients (1480, 84.2%) received sofosbuvir/ledipasvir (SOF/LDV) ± ribavirin (RBV); 278 (15.8%) received sofosbuvir/Daclatasvir (SOF/DCV) ± RBV. The median age of the patients was 57 years, (interquartile range (IQR) 46–64 years) The baseline HCV viral load (log IU/ml) was significantly higher in patients infected with genotype 6 compared with those infected with genotype 1 (6.8, 5.3–6.6 versus 6.3, 5.3–6.5 log10 IU/ml, p = <0.001, Mann Whitney U test). A sustained virological response (SVR), defined as an undetectable viral load measured between 12 and 24 weeks after completing treatment, and indicating cure, was seen in 97.3% (1711/1758) of patients. Treatment failure, defined as HCV viral load ≥15 IU/ml ≥12 weeks after completing treatment appeared to be more frequent in patients infected with genotype 6 virus (3.2%, 37/1148) than in those infected with genotype 1 (1.7%, 10/610), p = 0.050 chi-squared test). We found no evidence that patient’s age, gender, liver cirrhosis, diabetes, HBV or HIV coinfection, prior treatment failure with pegylated interferon therapy, body mass index (BMI), aspartate aminotransferase to platelet ratio index (APRI), or fibrosis 4 (FIB-4) index were associated with treatment failure. Conclusions Our study suggests that patients with HCV genotype 6 infection in Vietnam may respond less well to treatment with sofosbuvir based DAAs than patients with genotype 1 infections. Further studies are needed to confirm this observation and to define whether it is driven by genotype-specific mutations.
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Affiliation(s)
| | - Thanh Thi Thanh Tran
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ngoc My Nghiem
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Phuong Thanh Le
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Quang Minh Vo
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Jeremy Day
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
- * E-mail:
| | - Hung Mạnh Le
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
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