Research Article| Volume 63, ISSUE 2, P329-336, August 2015

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Liver-directed gene therapy of chronic hepadnavirus infection using interferon alpha tethered to apolipoprotein A-I

Published:March 14, 2015DOI:

      Background & Aims

      Current hepatitis B virus (HBV) management is challenging as treatment with nucleos(t)ide analogues needs to be maintained indefinitely and because interferon (IFN)-α therapy is associated with considerable toxicity. Previously, we showed that linking IFNα to apolipoprotein A-I generates a molecule (IA) with distinct antiviral and immunostimulatory activities which lacks the hematological toxicity of IFNα.


      Here, we analyse the antiviral potential of an adeno-associated vector encoding IFNα fused to apolipoprotein A-I (AAV-IA) in comparison to a vector encoding only IFNα (AAV-IFN) in two animal models of chronic hepadnavirus infection.


      In HBV transgenic mice, we found that both vectors induced marked reductions in serum and liver HBV DNA and in hepatic HBV RNA but AAV-IFN caused lethal pancytopenia. Woodchucks with chronic hepatitis virus (WHV) infection that were treated by intrahepatic injection of vectors encoding the woodchuck sequences (AAV-wIFN or AAV-wIA), experienced only a slight reduction of viremia which was associated with hematological toxicity and high mortality when using AAV-wIFN, while AAV-wIA was well tolerated. However, when we tested AAV-wIA or a control vector encoding woodchuck apolipoprotein A-I (AAV-wApo) in combination with entecavir, we found that AAV-wApo-treated animals exhibited an immediate rebound of viral load upon entecavir withdrawal while, in AAV-wIA-treated woodchucks, viremia and antigenemia remained at low levels for several weeks following entecavir interruption.


      Treatment with AAV-IA is safe and elicits antiviral effects in animal models with difficult to treat chronic hepadnavirus infection. AAV-IA in combination with nucleos(t)ide analogues represents a promising approach for the treatment of HBV infection in highly viremic patients.

      Graphical abstract


      AAV (adeno-associated virus), AAV-IFN (adeno-associated vector encoding mouse interferon alpha), AAV-IA (adeno-associated vector encoding mouse interferon alpha fused to apolipoprotein A-I), AAV-Luc (adeno-associated vector encoding luciferase), AAV-wApo (adeno-associated vector encoding woodchuck apolipoprotein A-I), AAV-wIFN (adeno-associated vector encoding woodchuck interferon alpha), AAV-wIA (adeno-associated vector encoding woodchuck interferon alpha fused to apolipoprotein A-I), apoA-I (apolipoprotein A-I), HBV (hepatitis B virus), HBVTg (HBV transgenic mice), CHB (chronic hepatitis B), ELISA (enzyme-linked immunosorbent assay), EMCV (encephalomyocarditis virus), ETV (entecavir), IFNα (interferon-α), IA (interferon fused to apolipoprotein A-I), ISG15 (interferon-stimulated-gene 15), NAs (nucleoside/nucleotide analogues), 2′-5′ OAS (2′-5′-oligoadenylate synthetase), USP18 (ubiquitin specific peptidase 18), vg (viral genomes), WHV (woodchuck hepatitis virus), WHsAg (woodchuck hepatitis virus surface antigen)


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