Synergistic inhibition of intracellular hepatitis C virus replication by combination of ribavirin and interferon-α

Y Tanabe, N Sakamoto, N Enomoto… - Journal of Infectious …, 2004 - academic.oup.com
Y Tanabe, N Sakamoto, N Enomoto, M Kurosaki, E Ueda, S Maekawa, T Yamashiro…
Journal of Infectious Diseases, 2004academic.oup.com
Abstract Treatment of hepatitis C virus (HCV) infection with interferon (IFN)-α and ribavirin
combination therapy results in superior clinical antiviral responses than does monotherapy
with IFN. To explore the virological basis of the effects of combination therapy, we analyzed
the effects of IFN-α and ribavirin, singly and in combination, on intracellular HCV replication
by use of an HCV replicon system. A new replicon that expressed a selectable chimeric
reporter protein comprising firefly luciferase and neomycin phosphotransferase was …
Abstract
Treatment of hepatitis C virus (HCV) infection with interferon (IFN)-α and ribavirin combination therapy results in superior clinical antiviral responses than does monotherapy with IFN. To explore the virological basis of the effects of combination therapy, we analyzed the effects of IFN-α and ribavirin, singly and in combination, on intracellular HCV replication by use of an HCV replicon system. A new replicon that expressed a selectable chimeric reporter protein comprising firefly luciferase and neomycin phosphotransferase was constructed. The replicon was highly sensitive to IFN-α (50% inhibitory concentration [IC50], 0.5 U/mL). Therapy with ribavirin showed weak suppression of HCV replication at a lower concentration (IC50, 126 µmol/ L). The nucleotide sequence diversity of the replicon was increased significantly by therapy with ribavirin, suggesting that error-prone HCV replication was induced by the drug. Importantly, use of a clinically achievable concentration of ribavirin (∼0 µmol/L) in combination with IFN showed strong synergistic inhibitory effects on HCV replication. Our results suggest that the direct effects of ribavirin on the genetic stability of the HCV subgenome and its synergistic action combined, with IFN-α, may explain the improved clinical responses to combination therapy.
Oxford University Press