Journal
JOURNAL OF HEPATOLOGY
Volume 60, Issue 3, Pages 538-544Publisher
ELSEVIER
DOI: 10.1016/j.jhep.2013.11.010
Keywords
HDV mono-infection; HDAg; HBV super-infection; Human liver chimeric mice; Liver transplantation
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Funding
- German Research Foundation (Deutsche Forschungsgemeinschaft) [DFGDA1063/2, LU1707/1]
- DFG [SFB841]
- German Center for Infection Research (DZIF-BMBF) [TTU05.804]
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Background & Aims: Clinical studies have shown that hepatitis delta virus (HDV) infection can persist for years and intrahepatic latency of the large delta antigen (HDAg) has been detected following liver transplantation. However, large HDAg arising via RNA-editing is associated with increasing amounts of non-infectious HDV quasi-species. This study investigated whether HDV could persist intrahepatically in the absence of HBV in vivo and whether infectious HDV could subsequently be released following HBV super-infection. Methods: Humanized mice were infected with HDV particles lacking HBV. To test for rescue of latent HDV infection 3 and 6 weeks HDV mono-infected mice were super-infected with HBV. Viral loads and cell toxicity were determined by qRT-PCR and immunohistochemistry. Results: The presence of HDAg-positive human hepatocytes determined after 2, 3, and 6 weeks of HDV inoculation demonstrated establishment and maintenance of intrahepatic HDV mono-infection. Although intrahepatic amounts of large HDAg and edited HDV RNA forms increased over time in HDV mono-infected livers, HBV super-infection led to prompt viremia development (up to 10(8) HDV RNA and 10(7) HBV-DNA copies/ml) even after 6 weeks of latent mono-infection. Concurrently, the number of HDAg-positive human hepatocytes increased, demonstrating intrahepatic HDV spreading. The infectivity of the rescued HDV virions was verified by serial passage in naive chimeric mice. Conclusions: HDV mono-infection can persist intrahepatically for at least 6 weeks before being rescued by HBV. Conversion of a latent HDV infection to a productive HBV/HDV co-infection may contribute to HDV persistence even in patients with low HBV replication and in the setting of liver transplantation. (C) 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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