Influence of quadruple-infected patients on the effectiveness of antiviral therapy and analysis of drug resistance sites

Background HIV is prone to co-infection with hepatitis C virus and other viruses, which poses serious hazards and affects prevention and treatment outcomes. The aim of this study is to understand the risks of co-infection with multiple blood-borne diseases and the reasons for the poor outcome of antiviral therapy in patients. Methods In January 2024, serum samples were collected from HIV/HCV co-infected patients in a hospital in Yunnan Province, and the whole genome sequences of the patients were obtained by using second-generation sequencing, and phylogenetic trees were constructed and drug resistance loci were analyzed using Sangshin Informatics software. Results The phylogenetic tree showed that the patient's HCV strain was in the same evolutionary branch as HCV genotype 3b, and the BLAST results showed the highest nucleotide homology of 95.73%.The HGV strain was in the same evolutionary branch as HGV genotype 7, and the BLAST results showed the highest nucleotide homology of 98.85%, and the real-time fluorescent PCR showed that the EBV viral load was 3.34X10 ⁵ IU/ml, higher than the lower limit of EBV detection. X105IU/ml, which was higher than the lower limit of EBV detection.The patient was a case of mixed infection with HIV, HCV gene subtype 3b, HGV gene type 7, and EBV, and relapsed after failure of antiretroviral therapy. The results of HCV drug resistance site analysis showed that there was no drug resistance site mutation in the NS3 and NS5B gene regions, and amino acid site mutation sites A30K and L31M in the NS5A gene region, and the treatment regimen was adjusted to add RBV to the antiviral drug SOF/VEL/VOX regimen, and a 24-week SVR was obtained. Conclusions Therefore, the choice of SOF/VEL/VOX combined with RBV regimen may be an effective choice of treatment regimen for HCV3b-infected non-cirrhotic patients in the setting of multiple infections.