Lamivudine Therapy of WHV-Infected Woodchucks

Authors: Mason W.S.1; Cullen J.2; Moraleda G.1; Saputelli J.1; Aldrich C.E.1; Miller D.S.3; Tennant B.4; Frick L.5; Averett D.5; Condreay L.D.5; Jilbert A.R.3

Source: Virology, Volume 245, Number 1, May 1998 , pp. 18-32(15)

Publisher: Academic Press

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Abstract:

Hepatitis B viruses establish a chronic, productive, and noncytopathic infection of hepatocytes. Viral products are produced by transcription from multiple copies (5-50) of covalently closed circular (ccc) viral DNA. This cccDNA does not replicate, but can be replaced by DNA precursors that are synthesized in the cytoplasm. The present study was carried out to determine if long-term treatment with an inhibitor of viral DNA synthesis would lead to loss of virus products, including cccDNA, from the liver of woodchucks chronically infected with woodchuck hepatitis virus. Viral DNA synthesis was inhibited with the nucleoside analog, lamivudine (2\'-deoxy-3\'-thiacytidine). Lamivudine treatment produced a slow but progressive decline in viral titers in serum, to about 0.3% or less of the initial level. However, even after maintenance of drug therapy for 3-12 months, >95% of the hepatocytes in most animals were still infected. Significant declines in the percentage of infected hepatocytes and of intrahepatic cccDNA levels were observed in only three woodchucks, two in the group receiving lamivudine and one in the placebo control group. Moreover, virus titers eventually rose in woodchucks receiving lamivudine, suggesting that drug-resistant viruses began to spread through the liver starting at least as early as 9-12 months of treatment. Three types of mutation that may be associated with drug resistance were found at this time, in a region upstream of the YMDD motif in the active site of the viral reverse transcriptase. The YMDD motif itself remained unchanged. Not unexpectedly, the lamivudine therapy did not have a impact on development of liver cancer. Copyright 1998 Academic Press.

Language: English

Document Type: Research article

Affiliations: 1: Fox Chase Cancer Center, 7701 Burholme Avenue, Philadelphia, Pennsylvania, 19111 2: Department of Microbiology, Parasitology, and Pathology, North Carolina State University, Raleigh, North Carolina, 27066 3: Department of Microbiology and Immunology, University of Adelaide, Adelaide, South Australia, 5000, Australia 4: Department of Microbiology, Immunology and Parasitology, Cornell University, Ithaca, New York, 14853 5: Department of Virology, Glaxo Wellcome, Inc., Research Triangle Park, North Carolina, 27709

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