La majorité des individus exposés au virus de l’hépatite C (VHC) développent une infection chronique. Une réponse immunitaire adaptative forte et soutenue est associée avec la guérison spontanée du VHC, mais les mécanismes sous-jacents demeurent mal définis. Le rôle des cellules NK et des cellules dendritiques (DC) dans la guérison spontanée du VHC est encore méconnu. Les cellules NK sont la population effectrice la plus importante de l’immunité innée car elles tuent les cellules infectées et sécrètent diverses cytokines. Les DC reconnaissent des agents infectieux et elles sont les premières à initier et réguler l’immunité adaptative. Les cellules NK et les DC interagissent également entre elles afin de réguler l’immunité innée et adaptative. L’hypothèse du projet de doctorat est que l'activité des cellules NK pendant la phase aiguë de l'infection par le VHC module la fonction des DC afin que ces dernières puissent générer une réponse immunitaire adaptative capable d'éliminer le VHC. Le premier objectif était d’établir une corrélation entre l'activité des cellules NK et l'évolution de l'infection au VHC. Nous avons observé une augmentation de la cytotoxicité, mais une diminution de la sécrétion de cytokines par les cellules NK chez les patients chroniques et qui ont résolu spontanément pendant la phase aiguë en comparaison aux contrôles non infectés, démontrant alors une dissociation entre ces deux fonctions. Nos résultats suggèrent que les cellules NK sont activées pendant la phase aiguë indépendamment de l’évolution de l’infection. Le deuxième objectif était d’établir une corrélation entre le phénotype et la fonction des DC, et l'évolution de l'infection. Nous avons d’abord observé que les DC plasmacytoïdes de tous les patients infectés ont un phénotype plus immature que les contrôles, et que ce phénotype est plus prononcé chez les patients ayant résolu spontanément. De plus, en réponse à des stimulations, nous avons observé que pendant la phase aiguë précoce, les DC myéloïdes (mDC) de tous les patients infectés indépendamment de l’évolution de l’infection produisent davantage de cytokines en comparaison aux contrôles. Cependant, cette hyperréactivité n’est pas soutenue au cours de l’évolution chronique. Le troisième objectif était d’établir une corrélation entre les interactions NK/DC et l’évolution de l’infection. Nous avons étudié la capacité des cellules NK à lyser les DC potentiellement tolérogéniques, ainsi que la capacité des DC matures à activer les cellules NK, et nous avons observé aucune différence entre les patients infectés et les contrôles. Finalement, nous avons démontré pour la première fois la capacité des DC immatures à inhiber la fonction des cellules NK. En conclusion, nous avons démontré que les cellules NK sont activées pendant la phase aiguë de l’infection par le VHC indépendamment de l’évolution de l’infection. De plus, la capacité des cellules NK à éliminer les DC potentiellement tolérogéniques est intacte. Finalement, les mDC sont hyperréactives pendant la phase aiguë de l’infection, mais cette hyperréactivité n’est pas soutenue avec la persistance de l’infection. Cette perte d’hyperréactivité des mDC ne semble pas affecter la capacité des DC à activer les cellules NK, mais elle pourrait jouer un rôle dans l’inefficacité de l’immunité adaptative à éliminer le VHC. / The majority of individuals exposed to the hepatitis C virus (HCV) develop a chronic infection. It is known that a strong and sustained adaptive immune response is associated with the spontaneous clearance of HCV, however the underlying mechanisms are not well defined. The role of natural killer (NK) cells and dendritic cells (DCs) during the spontaneous resolution of HCV remains unknown. NK cells are the primary effector population of the innate immune response which are able to kill infected cells and secrete various cytokines. On the other hand, DCs are the first cell type to initiate and regulate adaptive immunity after recognizing infectious pathogens. NK cells and DCs can also interact reciprocally to further regulate innate and adaptive immunity. Our hypothesis is that NK cell activity during acute HCV will modulate DC function to prime a highly efficient adaptive immune response resulting in viral clearance. The first aim of my project was to establish a correlation between NK cell activity and the outcome of HCV infection. We observed increased NK cell cytotoxicity, but decreased cytokine secretion during acute HCV in patients with chronic evolution as well as spontaneous resolution, further demonstrating a dissociation between these two NK cell functions. Our results suggest that NK cells are activated during acute HCV infection regardless of infection outcome. The second aim was to establish a correlation between DC phenotype, function and the outcome of infection. We observed that plasmacytoid DCs (pDCs) from all HCV-infected patients have a more immature phenotype as compared to negative controls, yet this is more pronounced in spontaneous resolvers. Furthermore, we observed that during the early acute phase, myeloid DCs (mDCs) from all HCV-infected patients, regardless of outcome, have increased production of cytokines as compared to un-infected controls in response to stimulation. However, this hyperresponsiveness of mDCs is not sustained with chronic evolution. The third aim was to establish a correlation between the NK/DC cross-talk and infection outcome. We studied the capacity of NK cells to kill potentially tolerogenic DCs, as well as the capacity of mature DCs to activate NK cells, and we observed no major differences between different stages of HCV infection and un-infected controls. However, we obtained unprecedented data which suggests that immature DCs have the capacity to inhibit NK cell function. In conclusion, our results demonstrate that NK cells are activated during acute HCV infection regardless of its outcome. Furthermore, the capacity of NK cells to kill potentially tolerogenic DCs is intact for all groups of patients. Finally, mDCs are hyperresponsive during acute HCV, but this hyperresponsiveness is not sustained with persistence of viremia. The loss of mDC hyperresponsiveness does not seem to affect the capacity of DCs to activate NK cells, but might play a role in the capacity of DCs to prime a highly efficient adaptive immune response resulting in viral clearance.

No description available.

Le virus de l’hépatite C (VHC) est une des principales causes d’hépatite chronique. La protéine F du VHC est codée par un cadre de lecture alternatif du gène de la capside, Core. La protéine F a été découverte après que l’on ait associé Core à plusieurs des fonctions pathogènes du VHC. Nous proposons donc que certaines fonctions biologiques et pathogènes attribuées à la protéine Core résultent de l’activité de la protéine F. Nous avons choisi de développer trois lignées de poissons zébrés (Danio rerio) qui expriment différentes versions de la protéine F afin d’étudier les effets de la protéine F et leur incidence dans la pathogenèse du VHC. Deux versions de la séquence codant pour la protéine F (AF11 et AUG26) et une version mutante du gène core (CoremutI) ont été introduites sur les vecteurs d’un système d’expression répressible spécifique au foie. Ces vecteurs ont été co-injectés dans des embryons unicellulaires de poissons zébrés pour générer les poissons fondateurs des lignées transgéniques. 19, 21 et 36 poissons ont été choisis comme fondateurs pour les lignées AF11, AUG26 et CoremutI respectivement. De ce nombre, 9, 11 et 11 poissons ont atteint la maturité, dans l’ordre pour les mêmes lignées, et seront croisés pour donner naissance à des lignées transgéniques stables. Les résultats de ces expériences nous permettront de mieux cerner les propriétés biologiques de la protéine F et de définir son rôle dans la pathogenèse du VHC. / Hepatitis C virus (HCV) is a major cause of liver steatosis, fibrosis and hepatocellular carcinoma. HCV F protein is expressed from an alternative reading frame within the Core sequence. F protein was discovered after many of the pathogenic determinants of HCV had been associated with the effects of Core. Hence, we propose that a part of the functions attributed to Core result from the activity of the F protein. We produced and selected 19, 21 and 36 transgenic zebrafish (Danio rerio) to give rise to 3 independent lines expressing different versions of the F protein. Of these founders, 9, 11 and 11 were raised to maturity and will be bred to generate stable transgenic lines. Characterizing the phenotype of these transgenic fish will help determine the precise role of the F protein in the pathogenesis of hepatitis C.

La protéine core du virus de l’hépatite C (VHC) serait responsable des principaux effets pathogènes du VHC, dont le développement de fibrose, stéatose, cirrhose et carcinome hépatocellulaire. Un cadre de lecture alternatif existe dans le gène de core, permettant la synthèse d’une autre protéine appelée ARFP (pour alternatate reading frame protein) ou protéine F (pour frameshift), dont le rôle reste encore mal compris. La présence de la protéine F lors de l’étude des fonctions biologiques de core ne pouvant être exclue, il est possible que certains rôles attribués à core reflètent en réalité l’activité de la protéine F. Afin de déterminer les fonctions biologiques de la protéine F dans les hépatocytes et son influence dans la pathogenèse associée au VHC, nous avons généré des lignées transgéniques de poissons zébrés (Danio rerio) dans lesquelles l’expression de deux versions de la protéine F (AF11opti et AUG26opti) a été ciblée au foie par l’utilisation du promoteur de la liver fatty acid binding protein (L-FABP). Le phénotype des poissons transgéniques de génération F2 a été analysé au niveau morphologique, histologique et microscopique afin de rechercher des signes de pathologie hépatique. Nos résultats ont démontré l’implication de la protéine F dans le développement de stéatose hépatique chez les deux lignées transgéniques, mais aucun signe de fibrose ou d’oncogenèse n’a été détecté. L’identification des mécanismes cellulaires et moléculaires responsables de l’accumulation lipidique induite par la protéine F pourrait permettre de mieux comprendre son rôle dans la pathogenèse du VHC, et mener au développement de nouvelles stratégies antivirales. / Hepatitis C virus (HCV) core protein is thought to be responsible for the major pathogenic effects of HCV, including the development of fibrosis, steatosis, cirrhosis, and hepatocellular carcinoma. An alternate translational open reading frame exists in the core gene that allows the synthesis of another protein called ARFP (alternate reading frame protein) or F protein (frameshift), the role of which remains poorly understood. Since we cannot exclude the presence of F protein in most studies of core biological functions, it is possible that the roles attributed to core reflect the activity of ARFP. To determine the biological functions of F protein in hepatocytes and their influence on HCV-associated pathogenesis, we generated transgenic lines of zebrafish (Danio rerio) in which the liver fatty acid binding protein (L-FABP) promoter was used to direct liver-specific expression of two forms of ARFP (AF11opti and AUG26opti). The phenotype of F2 transgenic zebrafish was analyzed for morphological, histological and microscopic signs of liver-associated pathology. Our results demonstrated the implication of the HCV F protein in the development of hepatic steatosis in transgenic zebrafish liver but not fibrosis or oncogenesis. Identification of the cellular and molecular mechanisms underlying F protein-induced lipid accumulation will lead to a better understanding of the role of ARFP in HCV-associated pathology, which could lead to the development of novel antiviral strategies.

L’infection par le virus de l’hépatite C (VHC) évolue généralement vers le développement d’une hépatite C chronique, fréquemment associée à des perturbations métaboliques, (insulinorésistance et stéatose), et de la structure hépatique (fibrose et cirrhose), favorisant le développement d’un hépatocarcinome. Le stress oxydant semble étroitement lié à la progression de ces pathologies, notamment l’insulino-résistance. Or, les mécanismes moléculaires par lesquels le VHC module le stress oxydant restent confus, ainsi que l’effet réciproque du stress oxydant sur la réplication virale. Jusqu’à récemment, la modulation de ce stress a été étudiée in vitro dans des modèles non réplicatifs du VHC ou dans des modèles d’expression ectopiques des protéines virales. Peu d’études ont encore tenté de caractériser l’effet d’une infection complète et productive dans les cellules cibles naturelles du VHC, les hépatocytes. Mes travaux de recherche ont donc consisté à étudier la modulation de la balance redox cellulaire dans un modèle d’infection complet de type HCVcc, et dans les cellules hépatocytaires Huh7.5. Cette étude a permis de caractériser le stress oxydant dans ce modèle, mais surtout d’identifier un antioxydant à activité pro-virale, la glutathion peroxydase 4 (GPx4). En effet, nous avons observé une stimulation viro-induite de l’expression et de l’activité de GPx4, seule enzyme capable de détoxifier les lipides membranaires oxydés. L’expression de cette enzyme semble nécessaire à la réplication ainsi qu’à l’infectivité virale. Son importance pour le VHC résiderait dans son activité catalytique permettant de maintenir l’intégrité des lipides cellulaires nécessaire au cycle viral / Chronic infection with Hepatitis C virus (HCV) is frequently associated with metabolic disturbances (insulin-resistance and steatosis) as well as with changes to hepatic structure (fibrosis and cirrhosis) that favor hepatocellular carcinogenesis. Insulin resistance is in particular linked to oxidative stress, which is thought to play a key role in driving disease progression. However, molecular mechanisms by which HCV regulates oxidative stress are still unclear and reciprocally, the effect of oxidative stress on viral life cycle is not well understood. Until recently, induction of oxidative stress by HCV has mainly been investigated in non replicative in vitro models or in cell systems expressing viral proteins alone. Few studies have yet investigated oxidative stress in the context of productive HCV infection. My work consisted of studying the modulation of the cellular redox system using the HCVcc infection model, based on a replicative HCV isolate and the hepatoma cell line Huh7.5. This work provided a broad characterization of how HCV induces and prevents oxidative stress and identified glutathion peroxidase 4 (GPx4) as a pro-viral antioxydant enzyme. Indeed, we observed an HCVinduced upregulation of expression and activity of GPx4. We also demonstrated that GPx4 expression is required for viral replication and infectivity. As GPx4 possesses a particular catalytic activity, which is the detoxification of oxidized membrane lipids, we investigated the impact of the accumulation of oxidized lipids on HCV replication. These studies showed that GPx4 is an important host factor for HCV life cycle by maintaining membrane lipid integrity in an oxidative cellular environment

BACKGROUND: The needle exchange programme (NEP) started in Sweden in 1986 in Lund and shortly after in Malmo. The first NEP in Stockholm opened in spring 2013. The NEP is a service aimed at intravenous drug users (IDU) from 18 years old, with a goal of preventing the blood borne diseases, such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV). With the on going HIV and Hepatitis epidemics, numerous countries around the world have adopted control strategies, such as the NEP to halt the spread of HIV, HBV, and HCV. The objective of this study was to examine if the needle exchange programme has decreased the incidence of HIV, HBV, and HCV in Sweden over a six-year period.  METHODS: Data for incidence and prevalence was extracted from the yearly reports of the Stockholm’s needle exchange programme from 2013 to 2018 and the yearly reports of the public health agency in Sweden from 2013 to 2018. The data was collected for Stockholm, and compared to Västra Götaland, and the whole of Sweden. RESULTS: The incidence of HIV was zero in 2013 and 2015 in the NEP. The incidence of HBV decreased to zero in 2013 in the NEP. There is an increased incidence of HCV in the NEP. CONCLUSION: The NEP has a protective effect through its combination of needle exchange, opiate substitute therapy, counselling, and vaccinations in reducing and stabilising incidences of the infections, in some instances to zero, as well as providing surveillance and treating infections.

Submitted by Cássio da Cruz Nogueira (cassionogueirakk@gmail.com) on 2017-09-28T15:31:27Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PrevalenciaHepatitePacientes.pdf: 1679476 bytes, checksum: c91c0f85a50b3f941073efbfc16ec5ac (MD5) / Approved for entry into archive by Irvana Coutinho (irvana@ufpa.br) on 2017-09-28T16:53:58Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PrevalenciaHepatitePacientes.pdf: 1679476 bytes, checksum: c91c0f85a50b3f941073efbfc16ec5ac (MD5) / Made available in DSpace on 2017-09-28T16:53:58Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_PrevalenciaHepatitePacientes.pdf: 1679476 bytes, checksum: c91c0f85a50b3f941073efbfc16ec5ac (MD5) Previous issue date: 2012 / A hepatite C é considerada um problema de saúde pública no Brasil e no mundo, com elevado risco de cronificação, além de complicações como adenocarcinoma hepatocelular e cirrose hepática. Os pacientes em hemodiálise têm elevado risco para infecção pelo vírus da hepatite C por motivos variados. Estudos apontam elevadas taxas de prevalência em unidades de diálise do mundo inteiro. No estado do Maranhão não há trabalhos que demonstrem o perfil do HCV na população de doentes renais crônicos. O principal objetivo deste estudo é avaliar a prevalência do vírus da Hepatite C nos pacientes submetidos a terapias de substituição renal na cidade de Imperatriz- Maranhão. Bem como, investigar os principais fatores de risco envolvidos na transmissão do HCV na população estudada. Trata-se de um estudo transversal, realizado na Clínica de Doenças Renais de Imperatriz, no período compreendido entre janeiro e dezembro de 2010. A população-alvo do estudo foi composta de 181 pacientes em terapia de substituição renal, hemodiálise ou diálise peritoneal. Foi utilizado um questionário elaborado para obtenção dos dados epidemiológicos e foi coletado amostra de sangue periférico, com o propósito de realizar a pesquisa para anticorpos anti-HCV e testes de Biologia Molecular para pesquisa de RNA viral e genotipagem. Os resultados demonstraram uma prevalência de 7,2% (13/181) para o HCV nos pacientes. Uma maior frequência do sexo masculino entre os portadores do HCV (92%). O fator de risco que se destacou foi o tempo de hemodiálise, onde 30,8% dos pacientes com mais de 15 anos de tratamento possuíam anticorpos contra o HCV e apresentaram alterações nos níveis de ALT. A prevalência da hepatite C foi elevada na unidade estudada. O tempo de tratamento dialítico foi considerado determinante para a positividade do vírus; o sexo masculino apresentou incidência mais elevada. Indivíduos com infecção crônica pelo HCV apresentaram níveis séricos de ALT mais elevados do que aqueles sem hepatite C crônica. / Hepatitis C is considered a public health problem in Brazil and worldwide, with a high risk of becoming chronic, and complications such as hepatocellular carcinoma and liver cirrhosis. Patients on hemodialysis have a high risk for infection with hepatitis C for many reasons. Studies show high prevalence rates in dialysis units worldwide. In the state of Maranhao there´s no studies showing the profile of HCV in the population of patients with chronic renal failure. The main objective of this study is to evaluate the prevalence of hepatitis C in patients undergoing renal replacement therapy in the city of Imperatriz-Maranhao. As well as to investigate the main risk factors involved in transmission of HCV in this population. This is a cross-sectional study conducted at a clinic of kidney diseases, the period between January and December 2010. The target population for the study consisted of 181 patients on renal replacement therapy, hemodialysis or peritoneal dialysis. We used a questionnaire designed to obtain epidemiological data was collected peripheral blood sample, in order to perform the search for anti-HCV testing and molecular biology research and genotyping of viral RNA. The results showed a prevalence of 7.2% (13/181) in HCV patients. A higher frequency of males among patients with HCV (92%). The risk factor that stood out was the duration of hemodialysis, where 30.8% of patients over 15 years of treatment had antibodies against HCV and had abnormal ALT levels. The prevalence of Hepatitis C was high in the study unit. The duration of dialysis was considered crucial for the positivity of the virus, males had higher incidence. Individuals with chronic HCV infection had ALT levels higher than those without chronic hepatitis C infection.

This thesis describes work done to design and synthesize protease inhibitors, with the intention of developing therapeutic agents for Alzheimer’s disease (AD) and the chronic liver condition caused by infection of the hepatitis C virus (HCV). AD is the most common form of dementia, and HCV infection is the primary reason for liver transplantation in industrialized countries. Today, these two illnesses affect 24 and 170 million people, respectively. It has been shown that the human aspartic protease BACE-1 plays an important role in the development of AD, and thus inhibition of BACE-1 may offer a way to improve the quality of life of individuals afflicted with the disease. Furthermore, it is known that the serine protease NS3 is a vital component in the replication of HCV. Several novel potent BACE-1 inhibitors encompassing different transition state mimics were prepared. First, a hydroxyethylene moiety encompassing a secondary hydroxyl group was evaluated as a transition state analogue, producing inhibitors in the low nanomolar range. Various tertiary hydroxyl isosteres were also investigated as the central core, with the aim of shielding the pivotal hydroxyl group. These transition state isosteres consisted of tertiary hydroxyl analogues of previously used secondary hydroxyl containing norstatine, statine, and hydroxyethylamine isosteres. Several tertiary hydroxyl-containing inhibitors were found to be active in the low micromolar range. In addition, two inhibitors were co-crystallized with the BACE-1 enzyme to provide X-ray crystal structures, which furnished valuable binding information for further design of improved BACE-1 inhibitors. The goal in the HCV NS3 protease inhibitor project was to design, synthesize and evaluate a novel hydroxycyclopentene bioisostere to the previously used acyl-hydroxyproline moiety. The investigation revealed that it was possible to synthesize inhibitors containing this new bioisostere that were potent in the low nanomolar range. Further optimization by rigidification of the most active inhibitor resulted in equipotent macrocyclic compounds.

Le virus de l’hépatite C (VHC) est une des principales causes d’hépatite chronique. La protéine F du VHC est codée par un cadre de lecture alternatif du gène de la capside, Core. La protéine F a été découverte après que l’on ait associé Core à plusieurs des fonctions pathogènes du VHC. Nous proposons donc que certaines fonctions biologiques et pathogènes attribuées à la protéine Core résultent de l’activité de la protéine F. Nous avons choisi de développer trois lignées de poissons zébrés (Danio rerio) qui expriment différentes versions de la protéine F afin d’étudier les effets de la protéine F et leur incidence dans la pathogenèse du VHC. Deux versions de la séquence codant pour la protéine F (AF11 et AUG26) et une version mutante du gène core (CoremutI) ont été introduites sur les vecteurs d’un système d’expression répressible spécifique au foie. Ces vecteurs ont été co-injectés dans des embryons unicellulaires de poissons zébrés pour générer les poissons fondateurs des lignées transgéniques. 19, 21 et 36 poissons ont été choisis comme fondateurs pour les lignées AF11, AUG26 et CoremutI respectivement. De ce nombre, 9, 11 et 11 poissons ont atteint la maturité, dans l’ordre pour les mêmes lignées, et seront croisés pour donner naissance à des lignées transgéniques stables. Les résultats de ces expériences nous permettront de mieux cerner les propriétés biologiques de la protéine F et de définir son rôle dans la pathogenèse du VHC. / Hepatitis C virus (HCV) is a major cause of liver steatosis, fibrosis and hepatocellular carcinoma. HCV F protein is expressed from an alternative reading frame within the Core sequence. F protein was discovered after many of the pathogenic determinants of HCV had been associated with the effects of Core. Hence, we propose that a part of the functions attributed to Core result from the activity of the F protein. We produced and selected 19, 21 and 36 transgenic zebrafish (Danio rerio) to give rise to 3 independent lines expressing different versions of the F protein. Of these founders, 9, 11 and 11 were raised to maturity and will be bred to generate stable transgenic lines. Characterizing the phenotype of these transgenic fish will help determine the precise role of the F protein in the pathogenesis of hepatitis C.

Hepatitis C virus (HCV) is a single-stranded plus-sense RNA virus that is transmitted by blood-to-blood contact, and infects the human liver. HCV has a unique dependence on the liver-specific microRNA miR-122, where miR-122 binds the 5´ un-translated region of the viral RNA at two tandem sites and increases viral RNA abundance. The mechanisms of augmentation are not yet fully understood, but the interaction is known to stabilize the viral RNA, increase translation from the viral internal ribosomal entry site (IRES), and result in increased viral yield. In an attempt to create a small animal model for HCV, we added miR-122 to mouse cell lines previously thought non-permissive to HCV, which rendered these cells permissive to the virus, additionally showing that miR-122 is one of the major determinants of HCV hepatotropism. We found that some wild-type and knockout mouse cell lines – NCoA6 and PKR knockout embryonic fibroblasts – could be rendered permissive to transient HCV sub-genomic, but not full-length, RNA replication upon addition of miR-122, and that other wild-type and knockout cell lines cannot be rendered permissive to HCV replication by addition of miR-122. These knockout cell lines demonstrated varying permissiveness phenotypes between passages and isolates and eventually completely lost permissiveness, and we were unable to achieve sub-genomic RNA replication in PKR knockout primary hepatocytes. Knockdown of NCoA6 and PKR in Huh7.5 cells did not substantially impact sub-genomic replication, leading us to conclude that there are additional factors within the cell lines that affect their permissiveness for HCV replication such as epigenetic regulation during passage or transformation and immortalization. We also added miR-122 to Hep3B cells, a human hepatoma cell line lacking expression of miR-122 and previously thought to be non-permissive to HCV replication. Added miR-122 rendered the cells as highly permissive to HCV replication as the Huh7-derived cell lines commonly used to study the virus. In these cells, we were also able to observe miR-122-independent replication of sub-genomic HCV RNA. This was verified by use of a miR-122 antagonist that had no impact on the putative miR-122-independent replication, and by mutating the miR-122 binding sites to make them dependent on a single nucleotide-substituted microRNA. This replication in the absence of miR-122 was not detected in full-length HCV RNA, but was detectable using a bi-cistronic full-length genomic replicon, suggesting that the addition of a second IRES in sub-genomic and full-genomic replicons altered replication dynamics enough to allow detectable RNA replication without miR-122 binding. Because miR-122 has been implicated in protecting the viral RNA from destabilization and degradation by Xrn1, the main cytoplasmic 5´ to 3´ RNA exonuclease, we employed our miR-122-independent system to test this miR-122-mediated protection. We verified that miR-122 functions to protect the viral RNA from Xrn1, but this was insufficient to account for the overall impact of miR-122 on replication, meaning that miR-122 has further functions in the virus’ life cycle. We showed that the effect of miR-122 on translation is due to stabilization of the RNA by protecting it from Xrn1, through binding at both sites. We further evaluated the role of each miR-122 binding site (S1 and S2) in the virus life cycle, and found that binding at each site contributes equally to increasing viral RNA replication, while binding at both sites exerts a co-operative effect. Finally, we determined that binding of miR-122 at site S2 is more important for protection from Xrn1, suggesting that miR-122 binding at S1 is more important for the additional functions of miR-122 in enhancing HCV RNA accumulation. Altogether, we have shown that miR-122 is partially responsible for the hepatotropic nature of Hepatitis C virus, and that supplementation with this microRNA can render non-permissive cells permissive to viral replication. We have also identified and confirmed replication of both sub-genomic and full-length HCV RNA in the absence of miR-122. Finally, we have characterized the impact of the host RNA exonuclease Xrn1 on the HCV life cycle, and determined the roles of each miR-122 binding site in shielding the viral RNA from this host restriction factor.