Hepatitis C virus cell-cell transmission and resistance to direct-acting antiviral agents

PLoS Pathog. 2014 May 15;10(5):e1004128. doi: 10.1371/journal.ppat.1004128. eCollection 2014 May.

Abstract

Hepatitis C virus (HCV) is transmitted between hepatocytes via classical cell entry but also uses direct cell-cell transfer to infect neighboring hepatocytes. Viral cell-cell transmission has been shown to play an important role in viral persistence allowing evasion from neutralizing antibodies. In contrast, the role of HCV cell-cell transmission for antiviral resistance is unknown. Aiming to address this question we investigated the phenotype of HCV strains exhibiting resistance to direct-acting antivirals (DAAs) in state-of-the-art model systems for cell-cell transmission and spread. Using HCV genotype 2 as a model virus, we show that cell-cell transmission is the main route of viral spread of DAA-resistant HCV. Cell-cell transmission of DAA-resistant viruses results in viral persistence and thus hampers viral eradication. We also show that blocking cell-cell transmission using host-targeting entry inhibitors (HTEIs) was highly effective in inhibiting viral dissemination of resistant genotype 2 viruses. Combining HTEIs with DAAs prevented antiviral resistance and led to rapid elimination of the virus in cell culture model. In conclusion, our work provides evidence that cell-cell transmission plays an important role in dissemination and maintenance of resistant variants in cell culture models. Blocking virus cell-cell transmission prevents emergence of drug resistance in persistent viral infection including resistance to HCV DAAs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing / metabolism
  • Antiviral Agents / pharmacology*
  • Carbamates
  • Cell Communication* / immunology
  • Cells, Cultured
  • Drug Resistance, Viral* / immunology
  • Hepacivirus / drug effects*
  • Hepacivirus / growth & development
  • Hepacivirus / physiology*
  • Hepatitis C / immunology*
  • Hepatitis C / pathology
  • Hepatitis C / virology*
  • Humans
  • Imidazoles / pharmacology
  • Oligopeptides / pharmacology
  • Proline / analogs & derivatives
  • Proline / pharmacology
  • Pyrrolidines
  • Valine / analogs & derivatives
  • Viral Load / immunology
  • Virus Internalization* / drug effects

Substances

  • Antibodies, Neutralizing
  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Oligopeptides
  • Pyrrolidines
  • telaprevir
  • N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
  • Proline
  • Valine
  • daclatasvir