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dc.contributor.authorNasu, Akihiroja
dc.contributor.authorMarusawa, Hiroyukija
dc.contributor.authorUeda, Yoshihideja
dc.contributor.authorNishijima, Norihiroja
dc.contributor.authorTakahashi, Kenja
dc.contributor.authorOsaki, Yukioja
dc.contributor.authorYamashita, Yukitakaja
dc.contributor.authorInokuma, Tetsuroja
dc.contributor.authorTamada, Takashija
dc.contributor.authorFujiwara, Takeshija
dc.contributor.authorSato, Fumiakija
dc.contributor.authorShimizu, Kazuharuja
dc.contributor.authorChiba, Tsutomuja
dc.contributor.alternative丸澤, 宏之ja
dc.contributor.alternative西島, 規浩ja
dc.description.abstractBackground and Aims : The hepatitis C virus (HCV) invariably shows wide heterogeneity in infected patients, referred to as a quasispecies population. Massive amounts of genetic information due to the abundance of HCV variants could be an obstacle to evaluate the viral genetic heterogeneity in detail. Methods : Using a newly developed massive-parallel ultra-deep sequencing technique, we investigated the viral genetic heterogeneity in 27 chronic hepatitis C patients receiving peg-interferon (IFN) α2b plus ribavirin therapy. Results : Ultra-deep sequencing determined a total of more than 10 million nucleotides of the HCV genome, corresponding to a mean of more than 1000 clones in each specimen, and unveiled extremely high genetic heterogeneity in the genotype 1b HCV population. There was no significant difference in the level of viral complexity between immediate virologic responders and non-responders at baseline (p = 0.39). Immediate virologic responders (n = 8) showed a significant reduction in the genetic complexity spanning all the viral genetic regions at the early phase of IFN administration (p = 0.037). In contrast, non-virologic responders (n = 8) showed no significant changes in the level of viral quasispecies (p = 0.12), indicating that very few viral clones are sensitive to IFN treatment. We also demonstrated that clones resistant to direct-acting antivirals for HCV, such as viral protease and polymerase inhibitors, preexist with various abundances in all 27 treatment-naïve patients, suggesting the risk of the development of drug resistance against these agents. Conclusion : Use of the ultra-deep sequencing technology revealed massive genetic heterogeneity of HCV, which has important implications regarding the treatment response and outcome of antiviral therapy.ja
dc.publisherPublic Library of Scienceja
dc.rights© 2011 Nasu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ja
dc.titleGenetic heterogeneity of hepatitis C virus in association with antiviral therapy determined by ultra-deep sequencing.ja
dc.type.niitypeJournal Articleja
dc.identifier.jtitlePloS oneja
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