Dynamic coinfection with multiple viral subtypes in acute hepatitis C.
BACKGROUND
Acute hepatitis C virus (HCV) infection is rarely studied, but virus sequence evolution and host-virus dynamics during this early stage may influence the outcome of infection. Hypervariable region 1 (HVR1) is genetically diverse and under selective pressure from the host immune response. We analyzed HVR1 evolution by frequent sampling of an acutely infected HCV cohort.


METHODS
Three or more pretreatment samples were obtained from each of 10 acutely infected subjects. Polymerase chain reaction amplification was performed with multiple primer combinations to identify the full range of sequences present. Positive samples were cloned and sequenced. Phylogenetic analyses were used to assess viral diversity.


RESULTS
Eight of the 10 subjects were coinfected with at least 2 HCV subtypes. Multiple subtypes were detected in individual samples, and their relative proportions changed through acute infection. The subjects with the most complex subtype structure also had a dynamic viral load; however, changes in viral load were not directly linked to changes in subtype.


CONCLUSIONS
This well-sampled cohort with acute HCV infection was characterized by dynamic coinfection with multiple viral subtypes, representing a highly complex virologic landscape extremely early in infection.
Institute for Emerging Infections, University of Oxford, Oxford, UK.
Jennifer A
JA
Smith
Judith H
JH
Aberle
Vicki M
VM
Fleming
Peter
P
Ferenci
Emma C
EC
Thomson
Peter
P
Karayiannis
Angela R
AR
McLean
Heidemarie
H
Holzmann
Paul
P
Klenerman
D000293:Adolescent; D000328:Adult; D001317:Austria; D003001:Cloning, Molecular; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification / Q000472:pathogenicity*; D006526:Hepatitis C / Q000175:diagnosis / Q000821:virology*; D054884:Host-Pathogen Interactions; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D011110:Polymorphism, Genetic; D012367:RNA, Viral / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014759:Viral Envelope Proteins / Q000235:genetics
C087035:E1 protein, Hepatitis C virus; D012367:RNA, Viral; D014759:Viral Envelope Proteins; C091015:glycoprotein E2, Hepatitis C virus