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Article

Late Relapse and Reinfection in HCV Patients Treated with Direct-Acting Antiviral (DAA) Drugs

1
Virology Unit, National Institute for Infectious Diseases, INMI Lazzaro Spallanzani IRCCS, Via Portuense 292, 00149 Rome, Italy
2
Infectious Disease—Clinical Department, National Institute for Infectious Diseases, INMI Lazzaro Spallanzani IRCCS, Via Portuense 292, 00149 Rome, Italy
3
Bristol-Myers Squibb Research and Development, Cambridge, MA 02142, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Allan Brasier
Received: 19 April 2021 / Revised: 9 June 2021 / Accepted: 14 June 2021 / Published: 16 June 2021
The risk of hepatitis C virus (HCV) recurrence after direct-acting antiviral (DAA) treatment is <0.5%. However, the distinction between HCV RNA late relapse and reinfection still represents a challenge in virological diagnostics. The aim of this study was to employ next-generation sequencing (NGS) to investigate HCV RNA recurrence in patients achieving a sustained virologic response (SVR) at least six months post-treatment. NGS was performed on plasma samples from six HCV-positive patients (Pt1–6) treated with DAA. NGS of HCV NS5B was analyzed before treatment (T0), after HCV RNA rebound (T1), and, for Pt3, after a second rebound (T2). Reinfection was confirmed for Pt5, and for the first rebound observed in Pt3. Conversely, viral relapse was observed when comparing T0 and T1 for Pt6 and T1 and T2 for Pt3. Z-scores were calculated and used to predict whether HCV-positive patient samples at different time points belonged to the same quasispecies population. A low Z-score of <2.58 confirmed that viral quasispecies detected at T0 and T1 were closely related for both Pt1 and Pt2, while the Z-score for Pt4 was suggestive of possible reinfection. NGS data analyses indicate that the Z-score may be a useful parameter for distinguishing late relapse from reinfection. View Full-Text
Keywords: hepatitis C virus; HCV; HCV reinfection; HCV late relapse; next-generation sequencing; NGS; phylogenetic hepatitis C virus; HCV; HCV reinfection; HCV late relapse; next-generation sequencing; NGS; phylogenetic
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MDPI and ACS Style

Minosse, C.; Gruber, C.E.M.; Rueca, M.; Taibi, C.; Zaccarelli, M.; Grilli, E.; Montalbano, M.; Capobianchi, M.R.; Antinori, A.; D’Offizi, G.; McPhee, F.; Garbuglia, A.R. Late Relapse and Reinfection in HCV Patients Treated with Direct-Acting Antiviral (DAA) Drugs. Viruses 2021, 13, 1151. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061151

AMA Style

Minosse C, Gruber CEM, Rueca M, Taibi C, Zaccarelli M, Grilli E, Montalbano M, Capobianchi MR, Antinori A, D’Offizi G, McPhee F, Garbuglia AR. Late Relapse and Reinfection in HCV Patients Treated with Direct-Acting Antiviral (DAA) Drugs. Viruses. 2021; 13(6):1151. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061151

Chicago/Turabian Style

Minosse, Claudia, Cesare E.M. Gruber, Martina Rueca, Chiara Taibi, Mauro Zaccarelli, Elisabetta Grilli, Marzia Montalbano, Maria R. Capobianchi, Andrea Antinori, Gianpiero D’Offizi, Fiona McPhee, and Anna R. Garbuglia. 2021. "Late Relapse and Reinfection in HCV Patients Treated with Direct-Acting Antiviral (DAA) Drugs" Viruses 13, no. 6: 1151. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061151

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