{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:01:39Z","timestamp":1792839699144,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic hepatitis C virus (HCV) infection affects 71 million individuals, mostly residing in low- and middle-income countries (LMICs). Direct-acting antivirals (DAAs) give high rates of sustained virological response (SVR) in high-income countries where a restricted range of HCV genotypes\/subtypes circulate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We studied United Kingdom\u2013resident patients born in Africa to examine DAA effectiveness in LMICs where there is far greater breadth of HCV genotypes\/subtypes. Viral genome sequences were determined from 233 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Full-length viral genomic sequences for 26 known subtypes and 5 previously unidentified isolates covering 5 HCV genotypes were determined. From 149 patients who received DAA treatment\/retreatment, the overall SVR was 93%. Treatment failure was associated primarily with 2 subtypes, gt1l and gt4r, using sofosbuvir\/ledipasvir. These subtypes contain natural resistance-associated variants that likely contribute to poor efficacy with this drug combination. Treatment failure was also significantly associated with hepatocellular carcinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>DAA combinations give high SVR rates despite the high HCV diversity across the African continent except for subtypes gt1l and gt4r, which respond poorly to sofosbuvir\/ledipasvir. These subtypes are widely distributed across Western, Central, and Eastern Africa. Thus, in circumstances where accurate genotyping is absent, ledipasvir and its generic compounds should not be considered as a recommended treatment option.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab110","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T20:13:56Z","timestamp":1614111236000},"page":"995-1004","source":"Crossref","is-referenced-by-count":14,"title":["Real-World Outcomes of Direct-Acting Antiviral Treatment and Retreatment in United Kingdom\u2013Based Patients Infected With Hepatitis C Virus Genotypes\/Subtypes Endemic in Africa"],"prefix":"10.1093","volume":"226","author":[{"given":"Elihu","family":"Aranday-Cortes","sequence":"first","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Patrick","family":"McClure","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham , Nottingham , United Kingdom"},{"name":"Wolfson Centre for Emerging Virus Research, University of Nottingham , Nottingham , United Kingdom"},{"name":"School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham , Nottingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Davis","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L","family":"Irving","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham , Nottingham , United Kingdom"},{"name":"Wolfson Centre for Emerging Virus Research, University of Nottingham , Nottingham , United Kingdom"},{"name":"School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham , Nottingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazeem","family":"Adeboyejo","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham , Nottingham , United Kingdom"},{"name":"Wolfson Centre for Emerging Virus Research, University of Nottingham , Nottingham , United Kingdom"},{"name":"School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham , Nottingham , United Kingdom"},{"name":"Olabisi Onabanjo University , Ago Iwoje , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Tong","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"da Silva Filipe","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vattipally","family":"Sreenu","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, Kings College Hospital National Health Service Foundation Trust , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mutimer","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital and University of Birmingham , Birmingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals National Health Service Foundation Trust , Sheffield , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E","family":"Cramp","sequence":"additional","affiliation":[{"name":"South West Liver Unit, Derriford Hospital and Peninsula Schools of Medicine and Dentistry , Plymouth , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma C","family":"Thomson","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan K","family":"Ball","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham , Nottingham , United Kingdom"},{"name":"Wolfson Centre for Emerging Virus Research, University of Nottingham , Nottingham , United Kingdom"},{"name":"School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham , Nottingham , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McLauchlan","sequence":"additional","affiliation":[{"name":"MRC\u2013University of Glasgow Centre for Virus Research , Glasgow , United 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