HCV AND HEPATITIS HCV epidemiology and treatment failure Arevir - PowerPoint PPT Presentation

HCV AND HEPATITIS HCV epidemiology and treatment failure Arevir meeting, 04.05.2019 | Saleta Sierra

Geno2pheno [HCV] Team

Geno2pheno [HCV] USAGE

Geno2pheno [HCV] USAGE

PEPSI Study in numbers • 2882 Patienten • 4759 Proben • 46 DAA-therapy failing patients

PEPSI PROJECT MAIN CONTRIBUTORS Zentrum Abkürzung Stadt N Dres Isernhagen/Qurishi/Römer, Köln I1 Köln 541 Uniklinik Köln CGN1 Köln 457 mib Dienstleistung GmbH B3 Berlin 439 Uniklinik Düsseldorf DUS1 Düsseldorf 246 Prof. Dr. Goeser, Uniklinik Köln F1G Köln 245 Hepatitis-Ambulanz, Uniklinik Düsseldorf PO1 Düsseldorf 206 Dr. Peuser, Lüdenscheid P4 Lüdenscheid 106 Dres. Scholten und Schneeweiss, Köln S8 Köln 105 Dr. Niels Schübel, Klinikum Osnabrück M4 Osnabrück 98 MX01-Ambulanz, Uniklinik Düsseldorf O1 Düsseldorf 78 Dr. Christensen, Münster C2 Münster 76 Virologie Düsseldorf DUSV Düsseldorf 64 Dr. Kwirant, Duisburg K3 Duisburg 54 Hower, Klinikum Dortmund D1 Dortmund 46 Dr. Carls, Düsseldorf C3 Düsseldorf 36 Dr. Postel, München P5 München 27 PD. Dr. Sagir, Bethesda, Duisburg D2 Duisburg 27 Medizinische Hochschule Hannover C4 Hannover 24 Fachb. Virushepatologie, UKE, Hamburg H5 Hamburg 21 Poliklinik I, Uniklinik Bonn BN1 Bonn 18 Med. I, Haus 16, Uniklinik Köln F1 Köln 16 Praxis am Ebertplatz, Köln T1 Köln 15 Dr. Schäfer, Bielefeld S3 Bielefeld 11 Virologie Essen E2 Essen 10 HPSTD-Ambulanz, Uniklinik Essen E1 Essen 10

PEPSI AS PART OF EUROPEAN GT PROJECT

EU (+RUS, +ISL) GT ANALYSIS N = 37839, 52 centres

EU (+RUS, +ISL) GT DISTRIBUTION 0,1 0,2 9,0 10,5 25,6 64,9 20,9 28,9 4,8 GT2 GT3 GT4 GT5 GT6 GT1 GT1a GT1b

PEPSI PROJECT GT PREVALENCE (N=2207)

EU (+RUS, +ISL) GT DISTRIBUTION 100% 90% 80% GT1b 70% GT1a GT1 60% GT6 50% GT5 GT4 40% GT3 30% GT2 20% 10% 0% TOTAL España Italia Portugal Alemania Bélgica UK Israel Lux Rusia Austria

GT DISTRIBUTION PER GENDER 100% 90% 80% GT6 70% GT5 60% GT4 GT3 50% GT2 GT1b 40% GT1a GT1 30% 20% 10% 0% men women hombre mujer

GT DISTRIBUTION PER CO-INFECTION 100% 90% 80% 70% GT6 GT5 60% GT4 50% GT3 GT2 40% GT1b GT1a 30% GT1 20% 10% 0% HIV + HIV - HBV + HBV -

GT DISTRIBUTION PER AGE 100% 90% 80% 70% GT6 GT5 60% GT4 GT3 50% GT2 GT1b 40% GT1a GT1 30% 20% 10% 0% ≥65 64-55 54-45 44-35 34-25 24-15 ≤14

parenteral GT DISTRIBUTION PER TRANSMISSION ROUTE vertical nosocomial tattoo / piercing adicción Drugs drogas sexual MSM GT1 GT1a GT1b GT2 GT3 GT4 GT5 GT6

GT DISTRIBUTION GTs 2 and 1b ; GT4 increasing in other countries Epidemiology: • Females, > 60 years, nosocomial infection: GTs 1b or 2 • Males, < 45-50 years, on drugs: GTs 1a, and/or 3 • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4

GT DISTRIBUTION GTs 2 and 1b ; GT4 increasing in other countries Epidemiology: • Females, > 60 years, nosocomial infection: GTs 1b or 2 • Males, < 45-50 years, on drugs: GTs 1a, and/or 3 • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4 Limitations of the study: • Geographical coverage • Subtype NOT available when using commercial kits − Recombinants

HCV RECOMBINANTS DAA & sequence-based genotyping conventional genotyping targets targets [1] Galli & Bukh. Trends Microbiol . 2014. 22: 354; [2] Kurata et al. Hepatol Res . 2017;[3] Iles et al. J. Clin Microbiol 53: 3155; [4] Gaspareto et al Arch Virol 2016 161: 2161

GT DISTRIBUTION GTs 2 and 1b ; GT4 increasing in other countries Epidemiology: • Females, > 60 years, nosocomial infection: GTs 1b or 2 • Males, < 45-50 years, on drugs: GTs 1a, and/or 3 • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4 Limitations of the study: • Geographical coverage • Subtype NOT available when using commercial kits − Recombinants − “Exotic” subtypes • Limited epidemiological parameters collection (transmission)

THERAPY FAILURE: 46 PATIENTS

THERAPY FAILURE: 46 PATIENTS GT N undetermined 4 - 1a(I) 6 1a(I) 1a(II) 11 1a(II) 1b 11 1b 3a 8 3a 3b 1 3b 4d 2 4d 4k 4k 1 4n 4n 1 4r 4r 1 Total 46

THERAPY FAILURE: 46 THERAPIES Regimen N 3D 6 3D, RBV 1 GLE, PIB 2 GRZ, EBV 3 HRV 19 pIFN, RBV, BOC 2 pIFN, RBV, DCV 1 pIFN, RBV, SOF 2 pIFN, RBV, TVR 2 RBV, HRV 1 RBV, SMV, SOF 1 RBV, SOF 2 RBV, SOF, VEL 1 SOF, VEL 3 Total 46

THERAPY FAILURE: RAMs RAMs N no sequence 0 no 19 yes 23 Total 42 Gene N NS3 2 NS3, NS5A 1 NS3, NS5A, NS5B 2 NS5A 16 NS5B 2 Total 23

THERAPY FAILURE: RAMs RAMs N no sequence 0 no 19 yes 23 Total 42 Gene N NS3 2 NS3, NS5A 1 NS3, NS5A, NS5B 2 NS5A 16 NS5B 2 Total 23

THANKS AG Kaiser: Rolf Kaiser , Elena Knops, Eva Heger, Veronica di Cristanziano, Claudia Müller, Max Demagnez, Roland Schmidt, Kati Hutt, Michael Böhm, Heike Kulartz, Lisa Hüsgen

THANKS To you !!