Implications of hepatitis C virus subtype 1a migration patterns for virus genetic sequencing policies in Italy

Lize Cuypers, Bram Vrancken, Lavinia Fabeni, Nadia Marascio, Valeria Cento, Velia Chiara Di Maio, Marianna Aragri, Andrea Clemencia Pineda-Peña, Yoeri Schrooten, Kristel Van Laethem, Daniel Balog, Alfredo Focà, Carlo Torti, Frederik Nevens, Carlo Federico Perno, Anne Mieke Vandamme, Francesca Ceccherini-Silberstein

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In-depth phylogeographic analysis can reveal migration patterns relevant for public health planning. Here, as a model, we focused on the provenance, in the current Italian HCV subtype 1a epidemic, of the NS3 resistance-associated variant (RAV) Q80K, known to interfere with the action of NS3/4A protease inhibitor simeprevir. HCV1a migration patterns were analysed using Bayesian phylodynamic tools, capitalising on newly generated and publicly available time and geo-referenced NS3 encoding virus genetic sequence data. Results: Our results showed that both immigration and local circulation fuel the current Italian HCV1a epidemic. The United States and European continental lineages dominate import into Italy, with the latter taking the lead from the 1970s onwards. Since similar migration patterns were found for Q80K and other lineages, no clear differentiation of the risk for failing simeprevir can be made between patients based on their migration and travel history. Importantly, since HCV only occasionally recombines, these results are readily transferable to the genetic sequencing policy concerning NS5A RAVs. Conclusions: The patient migration and travel history cannot be used to target only part of the HCV1a infected population for drug resistance testing before start of antiviral therapy. Consequently, it may be cost-effective to expand genotyping efforts to all HCV1a infected patients eligible for simeprevir-based therapies.

Original languageEnglish
Article number70
JournalBMC Evolutionary Biology
Volume17
Issue number1
DOIs
Publication statusPublished - Mar 7 2017

Keywords

  • Europe
  • HCV
  • HCV1a
  • Italy
  • Phylogeography
  • Public health policy
  • Q80K
  • US

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics

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