Si la découverte récente de la souche virale JFH1, capable de réaliser un cycle viral complet en culture cellulaire, a permis de mieux caractériser le déroulement de l’infection du virus de l’hépatite C VHC, de nombreux aspects de la biologie du virus demeurent méconnus. Parmi ceux-ci, les mécanismes gouvernant l’encapsidation de l’ARN génomique viral au sein des particules restent à élucider. Cette thèse décrit la mise point d’un système de mobilisation hétérologue permettant l’analyse de l’interaction de la protéine de capside Core avec l’ARN viral. Ce système nous a permis d’identifier les régions de la protéine impliquées dans la liaison au génome viral, tout en autorisant son transfert dans des cellules naïves. Cette approche de mobilisation dépendante de la Core est complétée d’une étude de recrutement hétérologue basée sur la reconnaissance de l’ARN du phage MS2 avec la protéine de manteau Coat. Cette stratégie novatrice permet le recrutement efficace des ARNs marqués tout en autorisant leur localisation cellulaire. / The advent of infectious molecular clones of Hepatitis C virus (HCV) has unlocked the understanding of HCV life cycle. However, packaging of the genomic RNA, which is crucial to generate infectious viral particles, remains poorly understood. To study packaging in vivo, we developed a novel heterologous system to evaluate the interactions of HCV Core capside with viral RNA. This system allowed us to pinpoint Core domains involved in RNA binding, and package and transfer HCV RNA into a lentiviral vector. Aside from this Core dependent recruitment, we engineered retoviral vectors to trans-package MS2-tagged RNAs using MS2 Coat protein interaction. This system allowed us to efficiently recruit MS2-tagged replicons into naive cells and offers the opportunity to visualize HCV RNAs in Huh7.5 cells.

Les pDCs répondent aux infections virales par la production d'IFN-α. L'élimination du virus de l'hépatite C (VHC) chez plus de 50% des patients infectés par le traitement à l'IFN-alpha suggère que les pDCs jouent un rôle majeur dans le contrôle de l'infection VHC. Les pDCs exposées aux hépatocytes infectés par VHC, produisent beaucoup d'IFN-α. Néanmoins, en dépit de cette production par TLR7 par les pDCs, VHC continue à se répliquer dans le foie infecté. J'ai approfondi les connaissances des mécanismes moléculaires d'exploration des particules de VHC et des cellules infectées par le VHC par les pDCs. J'ai ciblé ma recherche sur le contact des particules de VHC avec la surface des pDCs, sur la voie de signalisation de déclenchée, sur leur effet sur la production des IFNs et des cytokines proinflammatoires et sur la différenciation cellulaire. Nos résultats suggèrent que le virus associé aux cellules signalise dans les pDCs via un mécanisme dépendant de l'endocytose et d'IRF7 mais pas de la voie NF-κB. En dépit de l'induction d'IFN-α, le VHC associé aux hépatocytes n'induit une réponse pleinement fonctionnelle des pDCs. Les particules virales de VHC inhibent, via la fixation de la glycoprotéine E2 aux CLRs, la production d'IFN-α et d'IFN-λ dans les pDCs exposées aux hépatocytes infectés par VHC et induisent dans les pDCs, une phosphorylation rapide d'Akt et Erk1/2, d'une manière similaire au crosslinking de BDCA-2 ou DCIR. Ainsi, le blocage de BDCA-2 et de DCIR avec des fragments Fab des anticorps monoclonaux préserve la capacité des pDCs à produire des IFNs de type I et III en présence des particules virales. / Plasmacytoid dendritic cells (pDCs) respond to viral infection by production of alpha interferon (IFN-alpha), proinflammatory cytokines, and cell differentiation. The elimination of hepatitis C virus (HCV) in more than 50% of infected patients by treatment with IFN-alpha suggests that pDCs play an important role in the control of HCV infection. pDCs exposed to HCV infected hepatoma cells produce large amounts of IFN-alpha. However, despite large amounts of Toll-like receptor 7-mediated IFN-α, produced by pDCs, HCV still replicates in infected liver. During my PhD training, I went into in depth to understand the molecular mecanisms used by HCV particles and HCV infected hepatocytes to explore pDCs. I focused my research on the binding of HCV particles with the pDC surface, on the triggered downstream signaling pathway, on the cellular differentiation. Our results suggest that cell-associated HCV signals in pDCs via an endocytosis-dependent mechanism and IRF7 but not via the NF-kappaB pathway. In spite of IFN-alpha induction, cell-associated HCV does not induce a full functional response of pDCs. HCV particles inhibit, via binding of E2 glycoprotein to CLRs, production of IFN-α and IFN-λ in pDCs exposed to HCV-infected hepatocytes, and induce in pDCs a rapid phosphorylation of Akt and Erk1/2, in a manner similar to the crosslinking of BDCA-2 or DCIR. Blocking of BDCA-2 and DCIR with Fab fragments of monoclonal antibodies preserves the capacity of pDCs to produce type I and III IFNs in the presence of HCV particles.

Le traitement du VHC connaît une évolution rapide avec le développement d'antiviraux à action directe plus efficaces et mieux tolérés qui vont modifier les stratégies thérapeutiques, les facteurs prédictifs de réponse et les modalités de suivi des patients. Notre travail s'intéresse aux paramètres de suivi du traitement que sont les dosages pharmacologiques de ribavirine et le suivi des cinétiques virales lors d'une trithérapie. L'étude d'une cohorte prospective incluant 186 patients sous trithérapie par IP montre que 60% d'entre-eux présentent une SVR12 et que les facteurs prédictifs sont le génotype de l'IL28B et la réponse au précédent traitement. Une diminution de la filtration glomérulaire réversible est également observée. La mesure du taux résiduel de ribavirine permet de réduire les risques hématologiques chez des patients insuffisants rénaux, la réalisation de l'ASC témoigne d'une moins bonne exposition à la ribavirine chez des patients co-infectés par le VIH/VHC et la biodisponibilité de la ribavirine et la sévérité des anémies augmentent chez des patients traités par télaprévir. Au sein de la cohorte CUPIC, la négativation ou la diminution >50-70% de la charge virale initiale à S2 de trithérapie sont fortement prédictives de la SVR12. Cette mesure à S2 permet aussi de dépister les échappements viraux précoces. La place de la ribavirine est importante dans les associations thérapeutiques actuelles et futures. Sa surveillance pharmacologique peut avoir un intérêt au cours de futures multi-thérapies exposant à d'éventuelles interactions médicamenteuses / The rapid development of new direct antiviral agents (DAA) against HCV gives hope of more potent and well tolerated treatments. These new compounds will deeply modify therapeutic schedules, virological response prognostic factors and patients’ monitoring. The aim of our work was to define the relevance of ribavirin plasma concentration and viral kinetics monitoring during triple therapy. The study of a prospective cohort including 186 patients under triple therapy showed an SVR12 rate of 60%. Associated predictive factors were IL-28B genotype and previous treatment response. A reversible decrease of glomerular filtration rate was also observed. Ribavirin plasma concentration monitoring reduced hematological risks among patients with renal insufficiency. Early ribavirin plasma exposure showed an underexposure among HIV/HCV patients and ribavirin biodisponibility with severe anemia increased among telaprevir-treated patients. Within the CUPIC cohort, the initial viral load undetectability or decrease up to 50% or 70% at week 2 of triple therapy were predictive of SVR12. Moreover, this week 2 viral load assessment allowed the detection of early viral breakthrough. Ribavirin still plays a major role in current and future therapeutic strategies. Ribavirin monitoring could also be important during future multi-drug therapy that could be associated with drug interactions

Translation initiation in the hepatitis C virus (HCV) occurs through a cap- independent mechanism that involves an internal ribosome entry site (IRES) capable of interaction with and utilization of the eukaryotic translational machinery. We focused on the structural configuration of the different HCV-IRES domains and the impact of IRES primary sequence variations on secondary structure conservation and function. For this purpose we introduced into our laboratory, methods such as denaturing gradient and temperature gradient gel electrophoresis for screening the degree of heterogeneity and total amount of HCV-IRES variability accumulated in HCV infected patients over a period of time. The selected samples showed variable migration pattern of the HCV-IRES (from all the patients) visualized in DGGE and TGGE, were sequenced and evaluated for translation efficiency using flow cytometry. In some cases, we discovered that multiple mutations, even those scattered across different domains of HCV-IRES, led to restoration of the HCV-IRES translational activity, although the individual occurrences of these mutations were found to be deleterious. We propose that such observation may be attributed to probable long- range inter- and/or intra-domain functional interactions. We established a large-scale HCV-IRES...

Made available in DSpace on 2016-08-10T10:55:30Z (GMT). No. of bitstreams: 1 Kerlita Kyarely Goncalves.pdf: 1802020 bytes, checksum: c89e713a3c5e49161a0f905b69790e4a (MD5) Previous issue date: 2005-02-03 / Hepatitis C (HCV) is considered to be an important problem of public health, affecting millions of people all over the world; it is the most frequent cause of a chronic evolution resulting in grave and long term consequences. Prisoners are currently considered to be an important group of risk for diseases like Hepatitis C due to the conditions of confinement, social margination, drug dependence, low social-economic level, and precarious conditions of medical assistance in the prison atmosphere. The objective of this study was to identify the prevalence of Hepatitis C among the male population of a prison complex in the State of Goiás (Brazil) to try to detect any relation between the prison atmosphere and social factors which may contribute to the risk behavior of such a population. During the period of February to September of 2004, a universe of 270 inmates answered a questionnaire, soliciting social-economic and behavioral information; they then passed through examinations for the detection of anti-HCV antibodies. The prison population sampled in the correctional facilty of Goias was composed principally of white detainees, ranging in age from 21 to 30 years of age, in legal or common-law marriages, who studied up to the fourth grade and earned an average of one minimum salary (<US$100.00) per month before prison. Of the tested prisoners, 14,8% were positive for anti-HCV antibodies; 17,5% of these presented co-infection HCV-HIV. The statistically significant risk factors observed were: age equal to or greater than 31 years of age; the use of drugs, either injected or not; tattoos; sexual relations with a drug user and the occurrence of sexually transmitted diseases. These results suggest the importance of establishment a continuous health programs to make possible measures of control and prevention of HCV infection in the prison atmosphere. / A hepatite C (HCV) é considerada um importante problema de saúde pública, afetando milhões de pessoas em todo o mundo; é a causa mais freqüente de evolução crônica resultando em graves seqüelas a longo prazo. Na atualidade, os detentos são considerados um importante grupo de risco para doenças como a hepatite C, devido às condições de confinamento, marginalização social, dependência de drogas, baixo nível sócio-econômico e precárias condições de assistência médica nesse ambiente. Este estudo teve por objetivo identificar a prevalência de hepatite C na população masculina de detentos em regime fechado de um complexo prisional de Goiás, buscando detectar a relação entre o ambiente prisional e fatores sociais que possam contribuir para o comportamento de risco de tal população. No período de fevereiro a setembro de 2004, um universo de 270 detentos, responderam uma ficha cadastro/formulário contendo informações sócio-econômicas e comportamentais; depois eles passaram por exames para a detecção de anticorpos anti-HCV. A população carcerária da Agência Prisional de Goiás se caracteriza, principalmente, por detentos brancos variando em idade de 21 a 30 anos, casados/amasiados, que estudaram por até 4 anos e recebiam antes da prisão em média 1 salário mínimo mensalmente. Foi encontrada uma prevalência de 14,8% de detentos com anticorpos anti-HCV e 17,5% destes apresentaram coinfecção HCV-HIV. Os fatores de risco estatisticamente significantes observados foram: a idade maior ou igual a 31 anos; o uso de drogas, injetáveis ou não; tatuagem; prática de sexo com usuário(a) de drogas e a ocorrência de doenças sexualmente transmissíveis. Esses resultados sugerem a importância do estabelecimento de programas de saúde contínuos a fim de possibilitar medidas de controle e prevenção dessa infecção no ambiente prisional.

Translation is the process by which proteins are synthesized from the instructions in the genetic code. Translation is mediated by the ribosome, a large ribonucleoprotein complex, in concert with messenger RNA (mRNA), transfer RNA (tRNA), and a variety of proteins. The canonical mechanism of translation, introduced in Part I of my thesis, is divided into four distinct phases: initiation, elongation, termination, and recycling. Under unusual circumstances, each phase of translation can also proceed via a number of noncanonical mechanisms, many of which are vitally important for cellular growth or viral infectivity. My thesis describes structural insights into two such noncanonical mechanisms. The aim of the first project, described in Part II, was to structurally characterize a noncanonical mechanism of translational termination in bacteria. In the absence of a stop codon, ribosomes arrest at the 3′ end of an mRNA and are unable to terminate. In bacteria, the primary mechanism for rescuing such nonstop complexes is known as trans-translation. In the absence of a functional trans-translation system, however, the small protein ArfA recognizes the empty mRNA channel and recruits the release factor RF2 to the ribosome, enabling termination to occur. Using single-particle electron cryomicroscopy (cryo-EM), I obtained four high-resolution structures of nonstop complexes that reveal the mechanism of ArfA-mediated ribosome rescue and have wider implications for understanding canonical termination in bacteria. The aim of the second project, described in Part III, was to gain structural insights into a noncanonical mechanism of translational initiation in eukaryotes known as internal ribosome entry. Instead of a 5′ cap, many viruses contain intricately structured, cis-acting internal-ribosome-entry sites (IRESs) within their genomes that direct end-independent initiation. The IRES of hepatitis-C virus (HCV), for example, interacts directly with the mammalian ribosome and functionally replaces many of the canonical initiation factors. However, the mechanism by which the HCV IRES coordinates assembly of an initiation complex and progresses through the initiation phase remains poorly understood. I developed a method for purifying native ribosomal complexes from cell lysate that enabled me to obtain multiple cryo-EM maps of the HCV IRES in complex with the 80S ribosome, including a previously unseen conformation of the IRES induced by rotation of the ribosomal small subunit, and to make progress towards capturing earlier steps in the initiation pathway.

L’infection chronique par le virus de l’hépatite C (VHC) conduit au développement de la fibrose et de la cirrhose qui risque d’évoluer vers le carcinome hépatocellulaire (CHC). La protéine de capside du VHC interagit avec de nombreuses protéines de l’hôte et en particulier avec Smad3, protéine majeure de la voie de signalisation du transforming growth factor beta (TGF-Β). Mon travail de thèse consistait à étudier les conséquences biologiques de l’interaction entre la protéine de capside avec la voie de signalisation du TGF-Β. Le VHC présente une grande variabilité génétique et des travaux du laboratoire ont montré l’existence de séquences différentes de protéines de capside du virus entre les régions tumorales (cT) et cirrhotiques (cNT) d’un même sujet. Nous avons montré que ces différentes protéines de capside exprimées dans des hépatocytes orientent les réponses biologiques du TGF-Β vers la promotion tumorale en diminuant l’apoptose et en augmentant la transition épithelio-Mésenchymateuse (TEM) en particulier le variant cT. Cet effet est attribué à la capacité de la protéine de capside de diminuer l’activité transcriptionnelle de Smad3. De plus, les variants de la protéine de capside activent le TGF-Β latent via l’augmentation de l’expression de la trombospondine. L’un des marqueurs classiquement exprimé au cours d’une TEM est l’alpha-Actine musculaire lisse (αSMA). Nous avons montré qu’une autre isoforme, la γSMA, était polymérisée dans les cellules hépatiques développant une TEM. L’expression de γSMA a été retrouvée sur des coupes de CHC et a pu être significativement corrélée à la fois avec des marqueurs de la TEM, des marqueurs progéniteurs et avec l’agressivité de la tumeur.Ce travail apporte une meilleure compréhension du rôle de la protéine de capside dans la fibrose hépatique liée à l’infection virale. En effet, la protéine de capside du VHC agit à la fois de façon autocrine dans les hépatocytes en modulant les réponses du TGF-Β vers la promotion tumorale et de façon paracrine, en affectant l’activation des cellules étoilées en myofibroblastes par le TGF-Β activé. / Chronic HCV infection) may progress to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). HCV core binds several cellular proteins and in particular Smad3, a major protein of transforming growth factor beta (TGF-Β) signalling.. The aim of this study was to determine the implication of HCV core protein in TGF-Β responses. High genetic variability is a characteristic of HCV and it was previously shown that HCV core protein isolated from tumour (cT) or adjacent non-Tumour (cNT) livers displayed different sequences. Both were able to shift TGF-B responses from tumour suppressor to tumour promotor by decreasing hepatocyte apoptosis and increasing epithelial-Mesenchymal transition (EMT). Core cT was more potent than core cNT to promote this effect that was mainly attributed to the capacity of HCV core to alleviate Smad3 activity. Moreover, HCV core protein activated the latent form of TGF-Β through increased thrombospondin expression. It is commonly accepted that αSMA (alpha smooth muscle actin) is a hallmark of EMT. In the current study another SMA isoform, γSMA was found to be polymerized during hepatocyte EMT. γSMA was expressed in HCC tissues and correlated with EMT, stem cell and aggressiveness markers. In conclusion, this work contributed to a better understanding of the HCV core role in hepatitis fibrosis and HCC related to HCV. Indeed, HCV core might act both as an autocrine and paracrine way by modulating TGF-Β responses within hepatocytes and by activating hepatic stellate cells in stromal environment through its capacity to activate TGF-Β.

Les variants viraux impliqués dans la transmission du VHC ont rarement été étudiés en raison des difficultés rencontrées pour recruter des patients au stade de la primo-infection. Pour mener cette étude, nous avons analysé le goulot d’étranglement génétique subit par les quasi-espèces virales au cours de 3 accidents d’exposition au sang impliquant des représentants du personnel soignant contaminés par piqûre d’aiguille. En utilisant la technique d’amplification de génomes uniques nous avons obtenu les gènes codant les glycoprotéines d’enveloppe virales E1E2 des variants viraux présents dans ces quasi-espèces. Ces gènes ont été séquencés et soumis à une analyse phylogénétique. Nous avons ensuite pu étudier les propriétés phénotypiques des glycoprotéines d’enveloppe dérivées de variants qui apparaissent au stade très précoce de l’infection. Pendant cette période, le VHC pourrait être plus vulnérable à l’élimination par des vaccins préventifs ou par des immunothérapies. / Little is known about the transmitted variants responsible for the spread of HCV infection, principally because of the difficulties to recruit patients early enough in infection. To address this issue, we proposed to track the genetic bottleneck event in HCV quasispecies, leading to productive clinical infection in three health care workers accidentally contaminated through needlestick accidents. By using a single genome amplification (SGA) approach we identified genes coding the viral envelope glycoprotein E1E2 which composed these quasispecies. The E1E2 sequences were then directly sequenced and subjected to a phylogenetic analysis. By cloning these full-length E1E2 sequences, we investigated the phenotypic properties of the envelope glycoproteins potentially involved in selective HCV transmission and early stage of infection, a period during which the virus might be most vulnerable to elimination by preventive vaccines or immunotherapies.

Purpose of Review: The purpose of this review is to address infection with HIV and hepatitis C in the Appalachian region of the USA and the driving forces underlying this epidemic. We seek to discuss epidemiology of disease and the possible interventions to reduce incidence and burden of disease in this resource-limited area. Recent Findings: The rise of the opioid crisis has fueled a rise in new hepatitis C infection, and a rise in new HIV infection is expected to follow. Injection drug use has directly contributed to the epidemic and continues to remain a risk factor. Men who have sex with men remains a significant risk factor for HIV acquisition as well. Summary: Progress has been made in the battle against HIV and, to a lesser extent, hepatitis C, but much more can be done. Limited data on co-infection with HIV/HCV are currently available for this at-risk region, but it is clear that Appalachia is highly vulnerable to co-infection outbreaks. A multipronged approach that includes advances in assessment of co-infection and education for both patients and clinicians can help to recognize, manage, and ideally prevent these illnesses.

Aims: Untreated opioid use disorder (OUD) is associated with overdose, premature death and infectious disease, including human immunodeficiency virus (HIV) and Hepatitis C (HCV). While prior studies have shown that educational interventions are associated with improvements in HIV and HCV knowledge and reductions in risk behaviors, those examined to date have typically been time- and resource-intensive. We recently developed an HIV+HCV Education intervention which aims to improve HIV and HCV knowledge in a single visit using an automated iPad platform. In this project, we examined its ability, using a within-subject evaluation, to improve knowledge of HIV and HCV transmission and risks among adults with OUD. Methods: Participants were 25 adults with OUD who were enrolled in a 12-week randomized trial evaluating the efficacy of an Interim Buprenorphine Treatment (IBT) for reducing illicit opioid use while awaiting entry into community-based opioid treatment. Participants completed a baseline HIV+HCV knowledge assessment (Pre-Test) followed by corrective feedback, both administered via iPad. They then completed an interactive HIV flipbook and animated HCV video, also on iPad, followed by a second administration of the knowledge assessment (Post-Test). Finally, to evaluate whether any changes in knowledge persisted over time, the HIV+HCV assessment was administered again at 4 and 12 weeks following study intake. Results: At baseline (Pre-Test), participants answered 69% and 65% of items correctly on the HIV and HCV assessments, respectively. After completing the educational intervention, participants answered 86% of items correctly on both the HIV and HCV assessments (p’s<.001). These improvements in knowledge also persisted throughout the three-month study, with scores at Week 4 and 12 timepoints significantly greater than baseline (p’s<.001). Conclusion: An HIV+Hepatitis Education intervention delivered via a portable, automated iPad platform may produce significant and persistent improvements in HIV and HCV knowledge among adults with OUD. These data provide additional support for the use of mobile educational interventions for enhancing HIV and HCV knowledge in individuals at elevated risk for infectious disease. Support: This trial was supported by NIDA R34 DA3730385 (Sigmon) with additional support by NIDA T32 DA007242 (Higgins).