Dynamic coinfection with multiple viral subtypes in acute hepatitis C

Jennifer A. Smith, Judith H. Aberle, Vicki M. Fleming, Peter Ferenci, Emma C. Thomson, Peter Karayiannis, Angela R. McLean, Heidemarie Holzmann, Paul Klenerman

Research output: Contribution to journalArticlepeer-review


Introduction. Acute hepatitis C virus (HCV) infection is rarely studied, but virus sequence evolution and hostvirus 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.

Original languageEnglish
Pages (from-to)1770-1779
Number of pages10
JournalJournal of Infectious Diseases
Issue number12
Publication statusPublished - 15 Dec 2010


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