Drug resistance of a viral population and its individual intrahost variants during the first 48 hours of therapy

Clin Pharmacol Ther. 2014 Jun;95(6):627-35. doi: 10.1038/clpt.2014.20. Epub 2014 Jan 31.

Abstract

Using hepatitis C virus (HCV) and interferon (IFN) resistance as a proof of concept, we have devised a new method for calculating the effect of a drug on a viral population, as well as the resistance of the population's individual intrahost variants. By means of next-generation sequencing, HCV variants were obtained from sera collected at nine time points from 16 patients during the first 48 h after injection of IFN-α. IFN-resistance coefficients were calculated for individual variants using changes in their relative frequencies, and for the entire intrahost viral population using changes in viral titer. Population-wide resistance and presence of IFN-resistant variants were highly associated with pegylated IFN-α2a/ribavirin treatment outcome at week 12 (P = 3.78 × 10(-5) and 0.0114, respectively). This new method allows an accurate measurement of resistance based solely on changes in viral titer or the relative frequency of intrahost viral variants during a short observation time.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms
  • Antiviral Agents / therapeutic use*
  • Drug Resistance, Viral / physiology*
  • Drug Therapy, Combination
  • Genetic Variation
  • Hepacivirus / drug effects*
  • Hepatitis C / drug therapy*
  • Hepatitis C / virology*
  • Humans
  • Interferon-alpha / therapeutic use*
  • Molecular Sequence Data
  • Phylogeny
  • Polyethylene Glycols / therapeutic use*
  • Population
  • Predictive Value of Tests
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification
  • Real-Time Polymerase Chain Reaction
  • Recombinant Proteins / therapeutic use
  • Ribavirin / therapeutic use*
  • Treatment Outcome
  • Viral Load

Substances

  • Antiviral Agents
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a