Non-epidemic HCV genotypes in low- and middle-income countries and the risk of resistance to current direct-acting antiviral regimens

The hepatitis C virus (HCV) is an extremely diverse virus, subtypes of which are distributed variably around the world. Viral genotypes may be divided into epidemic subtypes; those that have become prevalent globally, and endemic subtypes that have a more limited distribution, mainly in Africa and A...

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Bibliographic Details
Published in:Journal of hepatology 2021-08, Vol.75 (2), p.462-473
Main Authors: Shah, Rajiv, Ahovegbe, Lucrece, Niebel, Marc, Shepherd, James, Thomson, Emma C.
Format: Article
Language:English
Subjects:
Antiviral agents
Antiviral Agents - administration & dosage
Antiviral Agents - standards
Clinical trials
Developing Countries - statistics & numerical data
Directly Acting Antivirals
Disease resistance
Drug Resistance - immunology
Drug Resistance - physiology
Elimination
Epidemics
Evolution
Genetic diversity
Genotype
Genotypes
Hepacivirus - genetics
Hepatitis C
Hepatitis C Virus
Humans
Resistance
Sequencing
Subtypes
SVR
Thematic Miniseries on HCV cure
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Summary:The hepatitis C virus (HCV) is an extremely diverse virus, subtypes of which are distributed variably around the world. Viral genotypes may be divided into epidemic subtypes; those that have become prevalent globally, and endemic subtypes that have a more limited distribution, mainly in Africa and Asia. The high variability of endemic strains reflects evolutionary origins in the locations where they are found. This increased genetic diversity raises the possibility of resistance to pan-genotypic direct-acting antiviral regimens. While many endemic subtypes respond well to direct-acting antiviral therapies, others, for example genotypes 1l, 3b and 4r, do not respond as well as predicted. Many genotypes that are rare in high-income countries but common in other parts of the world have not yet been fully assessed in clinical trials. Further sequencing and clinical studies in sub-Saharan Africa and Asia are indicated to monitor response to treatment and to facilitate the World Health Organization’s 2030 elimination strategy.
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2021.04.045