Viral Diversity Does Not Affect Treatment Outcomes in HCV

heaptitis C viral infection HCV
heaptitis C viral infection HCV
Researchers examined the association between treatment outcomes and intrapatient hepatitis C virus diversity.

For patients with hepatitis C virus (HCV), baseline viral diversity does not affect the treatment outcomes of sofosbuvir-containing regimens, according to results published in the Journal of Viral Hepatology.

The researchers investigated the relationship between intrapatient HCV diversity in NS5A and NS5B proteins and treatment outcome.

At baseline, patients who had HCV genotype 3 had the lowest viral diversity compared with patients with other HCV genotypes, and viral diversity was greater in NS5A than in NS5B proteins (<.0001).

Baseline viral diversity was not correlated with treatment outcome for sofosbuvir/velpatasvir or sofosbuvir/ribavirin. However, the viral diversity varied among patients treated with different regimens at virologic failure. Patients treated with sofosbuvir/velpatasvir experienced a decrease in viral diversity from baseline at relapse, whereas patients treated with sofosbuvir/ribavirin experienced an increase in viral diversity at relapse 27% of the time.

“While this shows that an increase in diversity is possible after relapse from a non-[ribavirin] regimen, the probability of this event is much higher after treatment with [ribavirin],” the researchers wrote.

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Drs. Bhardwaj, Miller, Brainard, McNally, Mo, Svarovskaia, Martin, and Chang are employed by and own stock in Gilead Sciences, Inc. Dr. Chodavarapu owns stock in Gilead Sciences, Inc. Drs. Wertheim, Murrell, and Ragonnet-Cronin are investigators on a grant from Gilead Sciences, and Dr. Wertheim is a research consultant for the Centers for Disease Control and Prevention. Dr. Feld has received research funding from Abbvie, Gilead, and Merck. Dr. Sulkowski has received research support from Gilead, Abbvie, and Merck and has served on advisory boards for Gilead, Abbvie, Merck, Janssen, and Trek. Dr. Mangia has received research support from Janssen and BMS and has served on advisory boards and as a consultant for BMS, Gilead Sciences, and MSD.


Bhardwaj N, Ragonnet-Cronin M, Murrell B, et al. Intrapatient viral diversity and treatment outcome in patients with genotype 3a hepatitis C virus infection on sofosbuvir-containing regimens. J Viral Hepat. 2017;1-10.