Author/Authors :
Kuznetsova, Tatiana National Institute for Health Development - Department of Virology, Estonia , Tallo, Tatjana National Institute for Health Development - Department of Virology, Estonia , Tallo, Tatjana Swedish Institute for Communicable Disease Control - Department of Diagnostics and Vaccine, Unit for Molecular Typing, Sweden , Brjalin, Vadim West-Tallinn Central Hospital - Department of Internal Medicine, Estonia , Reshetnjak, Irina National Institute for Health Development - Department of Virology, Estonia , Salupere, Riina University of Tartu - Department of Internal Medicine, Estonia , Priimagi, Ljudmilla National Institute for Health Development - Department of Virology, Estonia , Katargina, Olga National Institute for Health Development - Department of Virology, Estonia , Smirnova, Maria Federal State Budgetary Institution “Chumakov Institute of Poliomyelitis and Viral Encephalitides” of RAMS - Department of Hemorrhagic Fevers and Pilot Projects, Russia , Jansons, Juris Latvian Biomedical Research and Study Center - Protein Engineering Department, Latvia , Tefanova, Valentina National Institute for Health Development - Department of Virology, Estonia
Abstract :
Background: A substantial proportion of hepatitis C virus (HCV)-1b infected patients do not response to pegylated interferon-α plus ribavirin (PegIFNα/RBV) combination therapy that was partially associated with mutations in the non-structural 5A (NS5A) protein.Objectives: Analysis of NS5A polymorphisms in HCV genotype 1b pre-treatment serum samples from Estonian patients and their effect on the treatment response.Patients and Methods: Twenty-nine complete NS5A sequences obtained from patients with chronic HCV-1b infection who had received combined therapy with PegIFNα-2a/RBV were analyzed and compared with the prototype strain HCV-J. Twelve patients achieved a sustained virological response (SVR), 15 were non-SVR and 2 patients stopped treatment because of side effects.Results: No significant difference in total number of amino acid mutations was observed between isolates from SVR and non-SVR patients in any known regions of the NS5A protein. However, specific amino acid substitutions at positions 1989 and 2283 correlated significantly with SVR, mutations at positions 1979, 2107, 2171 and 2382 were associated with non-response to treatment and amino acid substitution at position 2319 was observed in relapsers. At phylogenetic analysis, NS5A nucleotide sequences have been subdivided into four groups characterized by the different treatment response. Twenty-four novel nucleotide polymorphisms and 11 novel amino acid polymorphisms were identified based on the phylogenetic tree topology.Conclusions: Specific amino acid substitutions correlating with the treatment response were found. Polymorphisms revealed by phylogenetic analysis may define the signature patterns for treatment susceptible and treatment resistant strains prevalent in Estonia.
Keywords :
Estonia , Hepatitis C , Ribavirin , Therapy
