Identifying factors resulting in poor treatment outcomes in patients infected with ‘rare’ HCV subtypes using whole genome sequencing (WGS)

Some HCV subtypes that are ‘rare’ in industrialised but common in developing countries, possess natural polymorphisms which may reduce the likelihood of achieving cure with DAAs. These ‘rare’ subtypes are more common in migrant populations and people of BAME background and may dominate after common subtypes are successfully eliminated. A better understanding of the viral genetic factors contributing to poor treatment outcomes will inform treatment strategies, optimising cure rates in key groups, supporting WHO elimination targets. The work leveraged Operational Delivery Networks (ODN) collaborations to understand treatment outcomes within specific and marginalised sub-populations, informing the most cost-effective therapy regimens for ‘rare’ subtypes.

Findings will inform commissioning of healthcare resources and national treatment guidelines as well as provide a scientific basis for the contribution of naturally occurring or emerging resistance to treatment outcomes in different ‘rare’ subtypes.