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Characterization of oseltamivir-resistant influenza virus populations in immunosuppressed patients using digital-droplet PCR: Comparison with qPCR and next generation sequencing analysis

Identifieur interne : 000244 ( Main/Exploration ); précédent : 000243; suivant : 000245

Characterization of oseltamivir-resistant influenza virus populations in immunosuppressed patients using digital-droplet PCR: Comparison with qPCR and next generation sequencing analysis

Auteurs : Maxime Pichon [France] ; Alexandre Gaymard [France] ; Laurence Josset [France] ; Martine Valette [France] ; Gilles Millat [France] ; Bruno Lina [France] ; Vanessa Escuret [France]

Source :

RBID : Hal:hal-01908998

English descriptors

Abstract

INTRODUCTION: The H275Y substitution in neuraminidase (NA) confers oseltamivir-resistance in A(H1N1) influenza viruses (IV). Droplet digital PCR (ddPCR) is a new technique to explore single nucleotide polymorphisms. The aim of this study was to compare the performances of reverse transcriptase (RT)-ddPCR, RT-qPCR and next generation sequencing (NGS). We also analyzed the proportions of H275Y-NA substitution for two immunosuppressed patients with sustained shedding of A(H1N1)pdm09 IV. METHODS: RT-qPCR was performed using the ABI7500 platform. RT-ddPCR was carried out using the QX200 ddPCR platform. We strengthened our results by a NGS assay (Ion PGM\texttrademark sequencer). Discrimination performance and sensitivity of the RT-ddPCR assay were evaluated using mixes of wild type (WT) and mutated H275Y-NA-coding segments. RESULTS: The performance of RT-ddPCR was better than RT-qPCR, using NGS assay as a gold standard. RT-ddPCR was able to detect 0.28% oseltamivir-resistant IV in a WT IV population and 0.55% WT IV in an oseltamivir-resistant IV population. For the first patient, the H275Y-NA substitution was selected by oseltamivir treatment and reached about 50% of the IV population before dropping to less than 2% after treatment discontinuation which was under the lower limit of quantification by RT-qPCR and RT-ddPCR (\textless2%) after treatment stop. Then, five days after oseltamivir was re-introduced, the H275Y-NA substitution rose up to 100%. For the second patient, the H275Y-NA substitution reached about 30% two days after oseltamivir discontinuation. CONCLUSION: RT-ddPCR demonstrated better performances than classical RT-qPCR to estimate oseltamivir-resistant IV proportions. This technique could be used to detect earlier emergence of H275Y-NA substitution.


Url:
DOI: 10.1016/j.antiviral.2017.07.021


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<orgName>Virpath-Grippe, de l'émergence au contrôle -- Virpath-Influenza, from emergence to control</orgName>
<orgName type="acronym">Virpath</orgName>
<date type="start">2016-01-01</date>
<desc>
<address>
<addrLine>Laboratoire de Virologie et Pathologies humaines – VirPathFaculté de médecine RTH LaennecBâtiment B7-11 rue Guillaume Paradin69372 Lyon cedex 08</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://ciri.inserm.fr</ref>
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<idno type="RNSR">201320572J</idno>
<orgName>Centre International de Recherche en Infectiologie - UMR</orgName>
<orgName type="acronym">CIRI</orgName>
<date type="start">2013-01-01</date>
<desc>
<address>
<addrLine>21 avenue Tony Garnier 69365 Lyon Cedex 07</addrLine>
<country key="FR"></country>
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<ref type="url">http://ciri.inserm.fr/</ref>
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<orgName>Institut National de la Santé et de la Recherche Médicale</orgName>
<orgName type="acronym">INSERM</orgName>
<desc>
<address>
<addrLine>101, rue de Tolbiac, 75013 Paris </addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.inserm.fr</ref>
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</org>
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<orgName>École normale supérieure - Lyon</orgName>
<orgName type="acronym">ENS Lyon</orgName>
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<addrLine>15 parvis René Descartes - BP 7000 - 69342 Lyon Cedex 07</addrLine>
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<ref type="url">http://www.ens-lyon.eu/</ref>
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<orgName>Université Claude Bernard Lyon 1</orgName>
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<addrLine>43, boulevard du 11 novembre 1918, 69622 Villeurbanne cedex</addrLine>
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<orgName>Université de Lyon</orgName>
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<addrLine>92 rue Pasteur - CS 30122, 69361 Lyon Cedex 07</addrLine>
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</address>
<ref type="url">https://www.universite-lyon.fr/</ref>
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<orgName>Centre National de la Recherche Scientifique</orgName>
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<country>France</country>
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<settlement type="city">Lyon</settlement>
<region type="region" nuts="2">Auvergne-Rhône-Alpes</region>
<region type="old region" nuts="2">Rhône-Alpes</region>
</placeName>
<orgName type="university">Université Claude Bernard Lyon 1</orgName>
<orgName type="institution" wicri:auto="newGroup">Université de Lyon</orgName>
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</author>
<author>
<name sortKey="Escuret, Vanessa" sort="Escuret, Vanessa" uniqKey="Escuret V" first="Vanessa" last="Escuret">Vanessa Escuret</name>
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<hal:affiliation type="laboratory" xml:id="struct-555608" status="INCOMING">
<orgName>Laboratoire de Virologie [GH Nord HCL, Lyon]</orgName>
<orgName type="acronym">CNR des virus influenza</orgName>
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<address>
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</address>
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<org type="institution" xml:id="struct-555606" status="INCOMING">
<orgName>Institut des Agents Infectieux [GH Nord HCL, Lyon]</orgName>
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</address>
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<country>France</country>
</affiliation>
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</analytic>
<idno type="DOI">10.1016/j.antiviral.2017.07.021</idno>
<series>
<title level="j">Antiviral Research</title>
<idno type="ISSN">0166-3542</idno>
<imprint>
<date type="datePub">2017-09</date>
</imprint>
</series>
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<textClass>
<keywords scheme="mix" xml:lang="en">
<term>Antiviral Agents</term>
<term>Drug Resistance</term>
<term>H1N1 Subtype</term>
<term>H275Y substitution</term>
<term>High-Throughput Nucleotide Sequencing</term>
<term>Human</term>
<term>Humans</term>
<term>Immunocompromised Host</term>
<term>Influenza</term>
<term>Influenza A Virus</term>
<term>Influenza viruses</term>
<term>Missense</term>
<term>Molecular Diagnostic Techniques</term>
<term>Mutation</term>
<term>Neuraminidase</term>
<term>Next generation sequencing</term>
<term>Oseltamivir</term>
<term>Oseltamivir resistance</term>
<term>RT-droplet digital PCR</term>
<term>RT-qPCR</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Viral</term>
<term>Viral Proteins</term>
</keywords>
</textClass>
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<front>
<div type="abstract" xml:lang="en">
<p>INTRODUCTION: The H275Y substitution in neuraminidase (NA) confers oseltamivir-resistance in A(H1N1) influenza viruses (IV). Droplet digital PCR (ddPCR) is a new technique to explore single nucleotide polymorphisms. The aim of this study was to compare the performances of reverse transcriptase (RT)-ddPCR, RT-qPCR and next generation sequencing (NGS). We also analyzed the proportions of H275Y-NA substitution for two immunosuppressed patients with sustained shedding of A(H1N1)pdm09 IV. METHODS: RT-qPCR was performed using the ABI7500 platform. RT-ddPCR was carried out using the QX200 ddPCR platform. We strengthened our results by a NGS assay (Ion PGM\texttrademark sequencer). Discrimination performance and sensitivity of the RT-ddPCR assay were evaluated using mixes of wild type (WT) and mutated H275Y-NA-coding segments. RESULTS: The performance of RT-ddPCR was better than RT-qPCR, using NGS assay as a gold standard. RT-ddPCR was able to detect 0.28% oseltamivir-resistant IV in a WT IV population and 0.55% WT IV in an oseltamivir-resistant IV population. For the first patient, the H275Y-NA substitution was selected by oseltamivir treatment and reached about 50% of the IV population before dropping to less than 2% after treatment discontinuation which was under the lower limit of quantification by RT-qPCR and RT-ddPCR (\textless2%) after treatment stop. Then, five days after oseltamivir was re-introduced, the H275Y-NA substitution rose up to 100%. For the second patient, the H275Y-NA substitution reached about 30% two days after oseltamivir discontinuation. CONCLUSION: RT-ddPCR demonstrated better performances than classical RT-qPCR to estimate oseltamivir-resistant IV proportions. This technique could be used to detect earlier emergence of H275Y-NA substitution.</p>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>France</li>
</country>
<region>
<li>Auvergne-Rhône-Alpes</li>
<li>Rhône-Alpes</li>
</region>
<settlement>
<li>Lyon</li>
</settlement>
<orgName>
<li>Université Claude Bernard Lyon 1</li>
<li>Université de Lyon</li>
</orgName>
</list>
<tree>
<country name="France">
<noRegion>
<name sortKey="Pichon, Maxime" sort="Pichon, Maxime" uniqKey="Pichon M" first="Maxime" last="Pichon">Maxime Pichon</name>
</noRegion>
<name sortKey="Escuret, Vanessa" sort="Escuret, Vanessa" uniqKey="Escuret V" first="Vanessa" last="Escuret">Vanessa Escuret</name>
<name sortKey="Gaymard, Alexandre" sort="Gaymard, Alexandre" uniqKey="Gaymard A" first="Alexandre" last="Gaymard">Alexandre Gaymard</name>
<name sortKey="Josset, Laurence" sort="Josset, Laurence" uniqKey="Josset L" first="Laurence" last="Josset">Laurence Josset</name>
<name sortKey="Lina, Bruno" sort="Lina, Bruno" uniqKey="Lina B" first="Bruno" last="Lina">Bruno Lina</name>
<name sortKey="Millat, Gilles" sort="Millat, Gilles" uniqKey="Millat G" first="Gilles" last="Millat">Gilles Millat</name>
<name sortKey="Valette, Martine" sort="Valette, Martine" uniqKey="Valette M" first="Martine" last="Valette">Martine Valette</name>
</country>
</tree>
</affiliations>
</record>

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