Naturally occurring hepatitis C virus protease inhibitors resistance‐associated mutations among chronic hepatitis C genotype 1b patients with or without HIV co‐infection

The aim of this study was to measure the frequency of natural mutations in hepatitis C virus (HCV) mono‐infected and HIV/HCV co‐infected protease inhibitor (PI)‐naive patients. Methods Population sequence of the non‐structural (NS)3 protease gene was evaluated in 90 HCV mono‐infected and 96 HIV/HCV co‐infected PI treatment‐naive patients. The natural prevalence of PI resistance mutations in both groups was compared. Results Complete HCV genotype 1b NS3 sequence information was obtained for 152 (81.72%) samples. Seven sequences (8.33%) of the 84 HCV mono‐infected patients and 21 sequences (30.88%) of the 68 HIV/HCV co‐infected patients showed amino acid substitutions associated with HCV PI resistance. There was a significant difference in the natural prevalence of PI resistance mutations between these two groups ( P  = 0.000). The mutations T54S, R117H and N174F were observed in 1.19%, 5.95% and 1.19% of HCV mono‐infected patients. The mutations F43S, T54S, Q80K/R, R155K, A156G/V, D168A/E/G and V170A were found in 1.47%, 4.41%, 1.47%/1.47%, 2.94%, 23.53%/1.47%, 1.47%/1.47%/1.47% and 1.47% of HIV/HCV co‐infected patients, respectively. In addition, the combination mutations in the NS3 region were detected only in HIV/HCV genotype 1b co‐infected patients. Conclusion Naturally occurring HCV PI resistance mutations existed in HCV mono‐infected and HIV/HCV co‐infected genotype 1b PI‐naive patients. HIV co‐infection was associated with a greater frequency of PI resistance mutations. The impact of HIV infection on baseline HCV PI resistance mutations and treatment outcome in chronic hepatitis C (CHC) patients should be further analyzed.