In-Host HEV Quasispecies Evolution Shows the Limits of Mutagenic Antiviral Treatments

Here, we report the in-host hepatitis E virus (HEV) quasispecies evolution in a chronically infected patient who was treated with three different regimens of ribavirin (RBV) for nearly 6 years. Sequential plasma samples were collected at different time points and subjected to RNA extraction and deep...

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Detalles Bibliográficos
Autores: Colomer-Castell, Sergi|||0000-0002-0307-7455, Gregori i Font, Josep|||0000-0002-4253-8015, Garcia-Cehic, D.|||0000-0002-0009-038X, Riveiro Barciela, Mar|||0000-0001-9309-2052, Buti, Maria|||0000-0002-0732-3078, Rando-Segura, Ariadna|||0000-0003-4555-7286, Vico-Romero, Judit|||0000-0003-2461-4317, Campos, Carolina|||0000-0002-0132-7027, Ibañez Lligoña, Marta|||0000-0003-3428-2168, Adombi, Caroline Melanie|||0000-0001-9739-9166, Cortese, Maria Francesca|||0000-0002-4318-532X, Tabernero, David|||0000-0002-1146-4084, Esteban Mur, Juan Ignacio|||0000-0001-5085-917X, Rodríguez Frías, Francisco|||0000-0002-9128-7013, Quer, Josep|||0000-0003-0014-084X
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:321350
Acceso en línea:https://ddd.uab.cat/record/321350
https://dx.doi.org/urn:doi:10.3390/ijms242417185
Access Level:acceso abierto
Palabra clave:Quasispecies
Deep sequencing
Variability
Rare haplotypes
Fitness
Mutagens
Descripción
Sumario:Here, we report the in-host hepatitis E virus (HEV) quasispecies evolution in a chronically infected patient who was treated with three different regimens of ribavirin (RBV) for nearly 6 years. Sequential plasma samples were collected at different time points and subjected to RNA extraction and deep sequencing using the MiSeq Illumina platforms. Specifically, we RT-PCR amplified a single amplicon from the core region located in the open-reading frame 2 (ORF2). At the nucleotide level (genotype), our analysis showed an increase in the number of rare haplotypes and a drastic reduction in the frequency of the master (most represented) sequence during the period when the virus was found to be insensitive to RBV treatment. Contrarily, at the amino acid level (phenotype), our study revealed conservation of the amino acids, which is represented by a high prevalence of the master sequence. Our findings suggest that using mutagenic antivirals concomitant with high viral loads can lead to the selection and proliferation of a rich set of synonymous haplotypes that express the same phenotype. This can also lead to the selection and proliferation of conservative substitutions that express fitness-enhanced phenotypes. These results have important clinical implications, as they suggest that using mutagenic agents as a monotherapy treatment regimen in the absence of sufficiently effective viral inhibitors can result in diversification and proliferation of a highly diverse quasispecies resistant to further treatment. Therefore, such approaches should be avoided whenever possible.