HCV NS5A 2209-2248 amino acid substitutions affect serum 2,5AS activities

Pkr Gene Expression and Response to Pegylated Interferon plus Ribavirin Therapy in Chronic Hepatitis C

Pegylated interferon (PEG-IFN) alpha combined with ribavirin is the current standard treatment for hepatitis C, but around 50% of patients do not respond for reasons that are not fully understood. To explore the regulation of IFN-inducible protein kinase (PKR), we have measured PKR mRNA levels in peripheral blood mononuclear cells (PBMCs) and in liver biopsies from patients with chronic hepatitis C. PBMCs were also analysed after in vitro incubation with IFN and during antiviral therapy. Non-responders to PEG-IFN plus ribavirin had pre-treatment PKR mRNA levels in PBMCs (0.1 ±0.0074) and in liver (0.102 ±0.051) that were significantly higher than those of responders (PBMCs: 0.023 ±0.014, P=0.0005; liver: 0.034 ±0.020; P=0.0002). On the other hand, PKR mRNA levels in PBMCs were similar in non-responders and in responders after in vitro exposure to IFN (0.434 ±0.301 vs 0.403 ±0.222; P=NS) and during therapy (0.31 ±0.10 vs 0.30 ±0.12; P=NS). These results indicate that in hepatitis C, non–responsiveness to IFN-alpha is associated with pre-treatment up-regulation of the PKR gene, evidence that the infecting hepatitis C virus is able to stimulate endogenous IFN production, being resistant to its antiviral effect. On the other hand, the PKR gene response to exogenous IFN was similar in responders and non-responders, at least in PBMCs, suggesting that variations in its activation are not major determinants of the outcome of antiviral treatment.

To interfere and to anti-interfere: the interplay between hepatitis C virus and interferon

As popular strategies used by numerous viruses, interception of interferon (IFN) signaling and inhibition of IFN-induced antiviral functions allow viruses to evade the host immune response and set up successful infections. Hepatitis C virus (HCV), the leading cause of chronic liver disease worldwide and a major public health hazard, causes persistent infection in the majority of infected individuals. IFN-based therapies, currently the only ones available for HCV infection, have been unable to eliminate viral infection in the majority of patients, and many studies suggest that HCV possesses mechanisms to antagonize the IFN-induced antiviral response. Multiple viral, host, and IFN-associated factors have been implicated in the interplay between HCV and IFN. Two viral proteins, NS5A and E2, became the focus of much attention and extensive study because of their abilities to inhibit IFN-induced, double-stranded RNA-activated protein kinase (PKR), a major mediator of the IFN-induced biologic response, and to perturb the IFN signaling pathway. In this review, we discuss the significance of the interferon sensitivity determining region (ISDR) within NS5A, which has been the subject of intense debates. In addition, we discuss the potential mechanisms by which NS5A interferes with IFN signaling and the current working models. Further understanding of the molecular mechanisms underlying the interaction between HCV and IFN will likely facilitate improvement of current IFN-based therapies and development of novel treatments for the HCV pandemic. Future HCV research will benefit from both the development of efficient, convenient model systems for viral propagation, and the utilization of high throughput, genomic-scale approaches.

Hepatitis C virus and interferon resistance

Interferon plays a critical role in the host's natural defense against viral infections and in their treatment. It is the only therapy for hepatitis C virus (HCV) infection; however, many virus isolates are resistant. Several HCV proteins have been shown to possess properties that enable the virus to evade the interferon-mediated cellular antiviral responses.

Hepatitis C virus and its pathogenesis

Hepatitis C virus is a major causative agent of chronic hepatitis and the development of hepatocellular carcinoma. However, the roles of this virus in these diseases remain to be clarified, although it is likely that cytotoxic T lymphocytes (CTL) play crucial roles in the clearance of virus-infected cells, thus causing inflammation. In many, cases the clearance is not sufficient to eradicate all infected cells. This may be due to insufficient activation of CTL. In addition, it is also likely that the virus has some mechanism to escape from clearance. One such mechanism may be the suppression of apoptosis by activation of NF-kB or mitogenic function by virus proteins, and these functions may also be linked to the development of hepatocellular carcinoma.