Rare and Novel Hepatitis C Virus Genotype Subtypes and Response to Sofosbuvir/Velpatasvir in A5360 (MINMON) Clinical Trial.
Win Min Han, Sunil Solomon, Sandra Wagner-Cardoso et al.
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In 30 seconds
This analysis of samples from the multicountry ACTG A5360 (MINMON) clinical trial characterized rare and novel hepatitis C virus (HCV) subtypes and assessed baseline resistance-associated substitutions and response to 12 weeks of sofosbuvir/velpatasvir. Of 399 participants, 389 (97.5%) were successfully genotyped; sequencing identified provisional novel genotype 4 subtypes and a putative genotype 7 subtype, 7c. All participants with initially unsubtyped infections achieved SVR12 despite baseline NS5A resistance-associated substitutions. Reduced response was seen mainly in genotype 3b infections, with SVR of 78%. Overall, response was high across genotypes, including rare and novel subtypes.
Key findings
- Of 399 participants, 389 (97.5%) were successfully genotyped.
- Whole-genome sequencing identified provisional novel genotype 4 subtypes and a putative new genotype 7 subtype, 7c.
- All participants with initially unsubtyped infections achieved SVR12 despite baseline NS5A resistance-associated substitutions.
- SVR was 78% among genotype 3b infections; reduced response was associated with the genotype’s resistance profile.
Why it matters
HCV genetic diversity can complicate treatment assessment, particularly where subtype data are limited. These findings show that sofosbuvir/velpatasvir achieved high response across a diverse set of genotypes, while highlighting genotype 3b as a group with lower SVR. Better recognition of uncommon subtypes and resistance patterns can inform evaluation of pangenotypic treatment performance.
What to keep in mind
The analysis used samples from a clinical trial and reports response for specific subtype groups; the abstract does not provide subgroup sizes or detailed comparative estimates.