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Objective: Direct-acting antivirals (DAAs) inhibit hepatitis C virus (HCV) infection by targeting viral proteins that play essential roles in the replication process. However, selection of resistance-associated variants (RAVs) during DAA therapy has been a cause of therapeutic failure. In this study, we wished to address whether such RAVs could be controlled by the co-administration of host-targeting entry inhibitors that prevent intrahepatic viral spread. Design: We investigated the effect of adding an entry inhibitor (the anti-scavenger receptor class B type I mAb1671) to a DAA monotherapy (the protease inhibitor ciluprevir) in human-liver mice chronically infected with HCV of genotype 1b. Clinically relevant non-laboratory strains were used to achieve viraemia consisting of a cloud of related viral variants (quasispecies) and the emergence of RAVs was monitored at high resolution using next-generation sequencing. Results: HCV-infected human-liver mice receiving DAA monotherapy rapidly experienced on-therapy viral breakthrough. Deep sequencing of the HCV protease domain confirmed the manifestation of drug-resistant mutants upon viral rebound. In contrast, none of the mice treated with a combination of the DAA and the entry inhibitor experienced on-therapy viral breakthrough, despite detection of RAV emergence in some animals. Conclusions: This study provides preclinical in vivo evidence that addition of an entry inhibitor to an anti-HCV DAA regimen restricts the breakthrough of DAA-resistant viruses. Our approach is an excellent strategy to prevent therapeutic failure caused by on-therapy rebound of DAA-RAVs. Inclusion of an entry inhibitor to the newest DAA combination therapies may further increase response rates, especially in difficult-to-treat patient populations.

7 pags.; 4 figs.; 1 tab., © 2015 American Chemical Society. We have investigated the use of tightly focused, temporally shaped femtosecond (fs)-laser pulses for producing nanostructures in two dielectric materials (sapphire and phosphate glass) with different characteristics in their response to pulsed laser radiation. For this purpose, laser pulses shaped by third-order dispersion (TOD) were used to generate temporally asymmetric excitation pulses, leading to the single-step production of subwavelength ablative and subablative surface structures. When compared to previous works on the interaction of tightly focused TOD-shaped pulses with fused silica, we show here that this approach leads to very different nanostructure morphologies, namely, clean nanopits without debris surrounding the crater in sapphire and well-outlined nanobumps and nanovolcanoes in phosphate glass. Although in sapphire the debris-free processing is associated with the much lower viscosity of the melt compared to fused silica, nanobump formation in phosphate glass is caused by material network expansion (swelling) upon resolidification below the ablation threshold. The formation of nanovolcanoes is a consequence of the combined effect of material network expansion and ablation occurring in the periphery and central part of the irradiated region, respectively. It is shown that the induced morphologies can be efficiently controlled by modulating the TOD coefficient of the temporally shaped pulses., This work has been partially supported by the Spanish MINECO projects TEC2011-22422 and MAT2013-33517. J.H.-R. acknowledges the FPI grant and the FPI-EEBB travel grant awarded by the Spanish Ministry of Science and Innovation. N.G., B.Z., C.S., M.W., and T.B. acknowledge support from the DFG priority program no. 1327.