1. Analysis of hepatitis C NS5A resistance associated polymorphisms using ultra deep single molecule real time (SMRT) sequencing
- Author
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Adam Ameur, Daniël Leenheer, Johan Lennerstrand, Assar Bergfors, and Anders Bergqvist
- Subjects
0301 basic medicine ,Hepatitis C virus ,HCV genotypes ,Hepacivirus ,Biology ,Viral Nonstructural Proteins ,medicine.disease_cause ,Virus Replication ,Antiviral Agents ,Polymerase Chain Reaction ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Virology ,Drug Resistance, Viral ,medicine ,Humans ,Clinical significance ,NS5A ,Pharmacology ,Sanger sequencing ,Polymorphism, Genetic ,Base Sequence ,High-Throughput Nucleotide Sequencing ,Hepatitis C ,Sequence Analysis, DNA ,medicine.disease ,030104 developmental biology ,Mutation ,symbols ,030211 gastroenterology & hepatology ,Pacific biosciences ,Single molecule real time sequencing - Abstract
Development of Hepatitis C virus (HCV) resistance against direct-acting antivirals (DAAs), including NS5A inhibitors, is an obstacle to successful treatment of HCV when DAAs are used in sub-optimal combinations. Furthermore, it has been shown that baseline (pre-existing) resistance against DAAs is present in treatment naive-patients and this will potentially complicate future treatment strategies in different HCV genotypes (GTs). Thus the aim was to detect low levels of NS5A resistant associated variants (RAVs) in a limited sample set of treatment-naive patients of HCV GT1a and 3a, since such polymorphisms can display in vitro resistance as high as 60000 fold. Ultra-deep single molecule real time (SMRT) sequencing with the Pacific Biosciences (PacBio) RSII instrument was used to detect these RAVs. The SMRT sequencing was conducted on ten samples; three of them positive with Sanger sequencing (GT1a Q30H and Y93N, and GT3a Y93H), five GT1a samples, and two GT3a non-positive samples. The same methods were applied to the HCV GT1a H77-plasmid in a dilution series, in order to determine the error rates of replication, which in turn was used to determine the limit of detection (LOD), as defined by mean + 3SD, of minority variants down to 0.24%. We found important baseline NS5A RAVs at levels between 0.24 and 0.5%, which could potentially have clinical relevance. This new method with low level detection of baseline RAVs could be useful in predicting the most cost-efficient combination of DAA treatment, and reduce the treatment duration for an HCV infected individual.
- Published
- 2015