No description available.

Host-pathogen interactions in Hepatitis C Virus infection: Deciphering the role of host proteins and microRNAs Hepatitis C virus (HCV) is a positive sense single stranded RNA virus belonging to the Hepacivirus genus of the Flaviviridae family. HCV genome consists of a single open reading frame flanked by highly structured 5‟ and 3‟ untranslated regions (UTRs) at both ends. Unlike cellular mRNAs, HCV RNA translation is independent of the cap structure and is mediated by an internal ribosomal entry site (IRES) present in the 5‟UTR. HCV replication begins with the synthesis of a complementary negative-strand RNA using the positive strand RNA genome as a template catalyzed by the NS5B RNA dependent RNA polymerase (RdRp). The de novo priming of HCV RNA synthesis by NS5B occurs at the very end of the 3‟UTR. The 3‟UTR is organized into highly structured regions namely the variable region, poly U/UC region and the 3‟X region. These regions contain cis-acting elements that determine the efficiency of viral replication. In addition, the interaction of trans-acting factors with the 3‟ UTR is also important for regulation of HCV replication. HCV 3‟UTR interacts with several cellular proteins such as the human La protein, polypyrimdine tract binding protein (PTB), poly (rC)-binding protein 2 (PCBP2) and Human antigen R (HuR). However, the molecular basis of regulation of viral replication by these proteins is not well understood. Many proteins that are hijacked by HCV as well as other cytoplasmic RNA viruses, such as La, PCBP2, HuR and PTB are RNA binding proteins (RBPs). They are involved in post transcriptional regulation of cellular gene expression. Thus the subversion of these proteins by the virus can affect their normal physiological functions. In addition to proteins, recent reports also describe the involvement of non-coding RNAs including microRNAs (miRNA) and long non coding RNAs (lncRNA) in HCV infection. miRNAs can either directly bind to the HCV genome and regulate its life cycle or indirectly modulate the expression of host proteins required by the virus. miRNAs that are differentially regulated in virus infected tissues or body fluids of infected patients can also serve as biomarkers for diagnosis of various stages of the disease. Hence, it was planned to study the role of host proteins and miRNAs in the HCV life cycle and pathogenesis to have novel insights into the biology of HCV infection. Riboproteomic studies have identified several host proteins that directly interact with the 5‟ and/or 3‟UTRs of the HCV RNA. One of the RNA binding proteins that predominantly interact with the 3‟UTR of HCV RNA was found to be HuR. In the present study, we have extensively characterized the interaction between HuR and HCV 3‟UTR and studied its functional implications in HCV life cycle along with other host factors. Characterizing the HCV 3’UTR–HuR interaction and its role in HCV replication HuR is a ubiquitously expressed member of the Hu family which shuttles between the nucleus and cytoplasm in response to stress. Whole genome siRNA knockdown and other studies have suggested that HuR is essential for HCV replication. However, the molecular mechanism of its involvement in this process was not clear. We observed that siRNA mediated knockdown of HuR reduces the HCV RNA and protein levels. Immunofluorescence studies indicated that HuR relocalizes from the nucleus to the cytoplasm in HCV infected cells. Through confocal microscopy and GST pulldown assays, we have demonstrated that HuR co localizes with the viral polymerase, NS5B and directly interacts with the NS5B protein. Membrane flotation assays showed that HuR is present in the detergent resistant membrane fractions which are the active sites of HCV replication. In addition to the interaction of HuR with the viral protein NS5B, we also characterized its interaction with the viral RNA. Direct UV cross linking assays and UV cross linking immunoprecipitation assays were performed to demonstrate the interaction of HuR with the HCV 3‟UTR. The RRM3, hinge region and RRM1 of HuR were found to be important for binding. Further, we observed that HuR competes with PTB for binding to the 3‟UTR when cytoplasmic S10 extracts or recombinant proteins were used in UV cross linking assays. In contrast, the addition of HuR facilitated the binding of La protein to the HCV 3‟UTR in the above assays. Competition UV cross linking assays indicated that both HuR and PTB bind to the poly U/UC region of the 3‟UTR while La binds to the variable region. HuR and La showed higher affinities for binding to the 3‟UTR as compared to PTB in filter binding assays. Since HuR and PTB interact with the same region on the 3‟UTR and HuR showed ~4 fold higher affinity for binding, it could displace PTB from the 3‟UTR. Next, we investigated the roles of HuR, PTB and La in HCV translation and replication in cell culture using three different assay systems, HCV sub genomic replicon, HCV bicistronic SGR-JFH1/Luc replicon as well as the infectious HCV full length RNA (JFH1). Results clearly indicated that HuR and La are positive modulators of HCV replication. Interestingly, PTB facilitated HCV IRES mediated translation but appeared to have a negative effect on HCV replication. The positive effectors, HuR and La showed significant co localization with one another in the cytoplasm in immunofluorescence studies. GST pulldown and coimmunoprecipitation experiments indicated protein-protein interactions between HuR and La but not between HuR and PTB. Through quantitative IP-RT assays, we demonstrated that the overexpression of HuR in HCV RNA transfected cells increases the association of La with the HCV RNA while HuR knockdown reduces the association of La with the HCV RNA. Previous studies in our laboratory have shown that La helps in HCV genome circularization. The addition of HuR significantly increased La mediated interactions between the 5‟UTR and the 3‟UTR of HCV RNA as monitored by 5‟-3‟ co precipitation assays, suggesting a possible mechanism by which cooperative binding of HuR and La could positively regulate HCV replication. Taken together, our results suggest a possible interplay between HuR, PTB and La in the regulation of HCV replication. Studying the role of HuR- associated cellular RNAs in HCV infection HuR belongs to the category of mRNA turnover and translation regulatory proteins (TTR-RBPs), which are capable of triggering rapid and robust changes in cellular gene expression. HuR plays a role in several post transcriptional events such as mRNA splicing, export, stability and translation. In the present study, we have investigated the possible consequences of relocalization of HuR on cellular processes in the context of HCV infection. We observed that 72h post transfection of infectious HCV-JFH1 RNA, there is an increase in the mRNA levels of some of the validated targets of HuR including the vascular endothelial growth factor A (VEGFA), dual specificity phosphatise 1 (MKP1) and metastasis - associated lung adenocarcinoma transcript (MALAT1). IP-RT assays demonstrated that the association of HuR with VEGFA and MKP1 was higher in HCV-JFH1 RNA transfected cells as compared to the mock transfected cells indicating that increase in HuR association could probably help in stabilization of these mRNAs. Interestingly, we observed that the association of HuR with the lncRNA MALAT1 decreases in the presence of HCV RNA, while its RNA levels increased. Earlier it has been reported that MALAT1 interacts with HuR and was predicted to interact with La. We confirmed the interaction of both HuR and La proteins with MALAT1 RNA in vitro and in the cell culture system. Results from our time course experiments suggest that relocalization of HuR and La upon HCV infection might decrease their association with the nuclear retained MALAT1 RNA leading to significant reduction in MALAT1 RNA levels at the initial time points. However at later time points, MALAT1 was found to be unregulated through activation of the Wnt/beta-catenin pathway as demonstrated using a chemical inhibitor against β-catenin. Since MALAT1 is a known regulator of epithelial mesenchymal transition (EMT) and metastasis, we further studied the physiological consequence of the observed increase in MALAT1 levels upon HCV infection. Cell migration and cell invasion studies suggested that the knockdown of MALAT1 led to the inhibition of HCV- triggered wound healing and matrigel invasion and also rescued the down regulation of E-Cadherin protein levels, an EMT marker. Our study highlights the importance of the lncRNA, MALAT1 in HCV infection and suggests its possible involvement in HCV induced HCC. Investigating the role of miRNAs in HCV pathogenesis and replication miRNAs can also regulate HCV infection and pathogenesis in multiple ways. It is known that under disease conditions, there is aberrant expression of intracellular as well as circulating miRNAs. We have investigated the expression profile of 940 human miRNAs in HCV infected patient serum samples to identify the differentially regulated miRNAs. miR-320c, miR-483-5p and the previously reported miR-125b were found to be upregulated in the serum of cirrhotic and non-cirrhotic HCV infected patient serum samples. All three miRNAs were also unregulated in the cell culture supernatant of HCV infected cells as well as within the HCV infected cells. miR-483-5p was specifically enriched in the exosomes isolated from patient serum samples. Knockdown of miR-320c and miR-483-5p did not have significant effect on HCV replication while knockdown of miR-125b affected HCV replication through regulation of one of its target genes, HuR. We observed that with time, miR-125b levels in HCV-JFH1 RNA transfected cells increase while the HuR protein levels decrease. Using luciferase reporter constructs, we demonstrated that the decrease in HuR protein levels is indeed mediated by miR-125b. Mutations in the target site of miR-125b in the HuR 3‟UTR prevented the down regulation of luciferase activity. Next we tested the effect of silencing miR-125b on HCV replication. Knockdown of miR-125b prevented the reduction in HuR protein levels but with no significant effect on HCV replication. It appeared that the HuR protein already present in the cytoplasm could be sufficient to support HCV replication. Hence similar experiments were carried out in cells depleted of HuR using either siRNA against HuR or a chemical inhibitor of nucleocytoplasmic transport of HuR, Leptomycin B. We observed that when the intracellular levels of HuR are reduced using either of the two approaches, there is a decrease in HCV replication. This is in accordance with the results obtained in the first part of the thesis. However when miR-125b was silenced in HuR depleted cells, we noticed an upregulation in the HuR protein levels by western blot analysis and a consequent increase in HCV RNA levels as quantified by qRT-PCR. From our findings, we can conclude that miR-125b mediated regulation of HuR plays an important role in HCV replication. We hypothesize that this could be a cellular response to HCV infection to which the virus responds by inducing protein relocalization. Altogether, these studies outline the importance of host factors including cellular proteins and non-coding RNAs in the regulation of HCV life cycle and pathogenesis. Results reveal the mechanistic insights into how HCV infection triggers host defense pathways, which are evaded by the virus by counter strategies.

No description available.

HCV genome is a positive sense single-stranded RNA containing a single open reading frame (ORF) flanked by untranslated regions (UTRs), 5’UTR and 3’UTR.Initiation of HCV RNA translation is mediated by internal ribosome entry site (IRES) present in 5’ UTR and this process is independent of cap-structure and requires only a small subset of canonical initiation factors. Hence, HCV IRES-mediated translation initiation mechanism is quite different from canonical cellular mRNA translation initiation. The IRES is organized into highly structured domains, namely domain II, III and IV. High affinity interactions between structured RNA elements present in the IRES and 40S ribosomal proteins mediate 40S recruitment to HCV IRES. However, details of the RNA elements and region of ribosomal proteins involved in these interactions are poorly understood. In recent days, RNA-based molecules like siRNAs, antisense RNAs and RNA decoys have become promising candidates for antiviral molecules. So designing short RNA molecules that target unique HCV translation initiation mechanism might help in developing novel anti-HCV molecules. HCV 3’UTR and antisense-5’ UTRs serve as sites for replication initiation to synthesize negative and positive strand and this process is catalyzed by NS5B protein (RNA-dependent RNA polymerase). Hence, host proteins binding to both 3’UTR and antisense-5’UTR might play important role in HCV replication. This puts the study of HCV RNA–host protein interactions and its role in viral translation and replication in perspective. Studying the HCV IRES-ribosomal protein S5 interactions and its role in HCV IRES function Previous studies from our laboratory have demonstrated that binding of La protein to GCAC close to initiator AUG enhances ribosomal protein S5 (RPS5) binding with HCV IRES and stimulates HCV translation. However in-detail study on HCV IRES–RPS5 interactions and its implication on HCV translation initiation were lacking. In present study computational modelling suggested that domain II and IV interact majorly with the beta hairpin structure and C-terminal helix of RPS5. Filter-binding and UV cross-linking studies with peptides derived from predicated RNA-binding region of RPS5 and mutational studies with RPS5 demonstrated that beta hairpin structure present in RPS5 is critical for IRES–RPS5 interaction. In parallel, we have studied RNA elements involved in the IRES–RPS5 interactions using deletions and substitution mutations, which we had generated on the basis of the computational model. Direct and competition UV cross-linking experiments performed with these IRES mutants and 40S subunits as a source of RPS5 suggested that structure and sequence of both domain II and IV play crucial role in IRES–RPS5 interactions. We further investigated the effect of these mutations on IRES activity by in vitro translation assay and found that all the mutants that were compromised in binding to RPS5 showed reduced IRES activity. Moreover, ribosome assembly experiments on HCV IRES demonstrated that mutations affecting IRES–RPS5 interactions result in reduction of 80S peak and slight increase of 48S peak. Since the 40S subunit had been previously reported to bind with HCV 3’UTR, we explored the possible interaction of RPS5 with HCV 3’UTR. From direct and competition UV cross-linking assays, we found that RPS5 does not bind to 3’UTR and the interaction is unique to IRES (5’UTR). Interestingly, partial silencing of RPS5 preferentially inhibited HCV translation with marginal effect on cap-dependent translation. Recently, reduction in 40S subunit abundance was reported to preferentially inhibit HCV translation. So, we investigated the abundance of free 40S subunit upon silencing RPS5 and results showed reduction in free 40S subunit level. So, we hypothesize that silencing of RPS5 reduces free 40S abundance to inhibit HCV translation. Taken together, results identified specific RNA elements present in HCV IRES that are critical for IRES–RPS5 interactions and demonstrated the role of these interactions in HCV translation initiation. Targeting ribosome assembly on HCV IRES using short RNAs Stem-loops (SL) IIIe and IIIf of HCV IRES are known to play an important role in stable IRES–40S complex formation. However interaction of these stem-loops with 40S subunit in isolation, independent of other regions of HCV IRES, was not studied. In this study, using electrophoretic mobility shift assay (EMSA) and sucrose gradient centrifugation experiments, we demonstrate that short RNA containing both SLIIIe and SLIIIf together (SLRef RNA) binds to 40S subunit, while short RNAs containing either of the stem-loops (SLRe RNA and SLRf RNA) lose their ability to interact with 40S subunit. Further, SLRef RNA inhibited ribosome assembly on the IRES, whereas SLRe and SLRf RNA failed to inhibit the same. Since SLRef RNA is derived from IRES, we investigated the interaction SLRef RNA with IRES–trans-acting factors (ITAFs). UV cross-linking of radio-labelled HCV IRES with cytoplasmic extract (S10) in presence of unlabelled short RNAs suggested possible interactions of La and RPS5 proteins with SLRef RNA. Studies with recombinant La protein and RPS5 further confirmed their interaction with SLRef RNA. Ex vivo experiments with HCV bicistronic RNA suggested that SLRef RNA specifically inhibits HCV translation. In addition to that SLRef RNA inhibited the HCV RNA synthesis in JFH1 HCV cell culture system. Moreover, specific delivery of pSUPER construct expressing SLRef RNA (pSUPERSLRef) to mice liver along with HCV bicistronic construct using Sendai virosomes demonstrated specific inhibition of HCV IRES activity by SLRef RNA in mice hepotocytes. In summary, short RNA derived from HCV IRES was shown to bind with La protein and RPS5 to inhibit ribosome assembly on HCV IRES. Further, targeted delivery of SLRef RNA into mice liver using Sendai virosome resulted in inhibition of HCV RNA translation in mice hepatocytes. Characterizing the interaction of host proteins with antisense-5’UTR and 3’UTR and its significance in HCV replication Antisense-5’UTR and 3’UTR of HCV RNA are the sites of replication initiation. Hence, host proteins binding to both of these RNA sequences are potential candidates for regulation of HCV replication. In this study, we have investigated host proteins binding with antisense-5’UTR and 3’UTRof HCV RNA by performing UV cross-linking experiments with cytoplasmic extract of Huh7 cells, and found that a protein of ~42kDa protein interacts with both antisense-5’UTR and 3’UTR. Based on earlier report, we predicted that the ~42kDa protein could be hnRNPC1/C2. Results of UV cross-linking followed by immuno pull-down (UV-IP assay) and UV cross-linking experiments with recombinant hnRNPC1 protein confirmed that hnRNPC1 indeed binds to antisense-5’UTR and 3’UTR. Further, filter-binding experiments demonstrated that hnRNPC1 protein binds to 3’UTR with higher affinity compared to antisense-5’UTR. Subsequently, we investigated the regions within 3’UTR and antisense-5’UTR that interact with hnRNPC1protein. Results demonstrated that poly-(U/UC) region of 3’UTR and region containing stem-loops SL-IIIa’, SL-IIIb’, SL-IIIcdef’ and SL-IV’ in antisense-5’UTR were mostly involved in the interaction. Interestingly, studies with confocal microscopy suggested that hnRNPC1/C2 re-localizes from nucleus to cytoplasm upon JFH1 infection, which might in turn influence HCV replication. To investigate the role of hnRNPC1/C2 in HCV replication, partial silencing of hnRNPC1/C2 was performed in HCV cell culture system (JFH1) and results demonstrated that hnRNPC1/C2 is critical for HCV RNA synthesis. However experiments with HCV bicistronic RNA suggested that hnRNPC1/C2 does not play significant role in HCV translation. Taken together, results suggested that hnRNPC1/C2 re-localizes from nucleus to cytoplasm upon JFH1 infection and binds to HCV 3’UTR and antisense- 5’UTR to regulate HCV replication. In summary, this thesis provides novel insights into the interaction of host proteins with HCV RNA and its significance in HCV translation and replication. Inhibition of the ribosome assembly and consequent reduction in HCV translation with mutations interfering with IRES–RPS5 interaction, reported in the present study, unfolds the novel role of this interaction in HCV translation. Further, results obtained in the present study with a small RNA SLRef, derived from HCV IRES, provide proof of concept for using short RNAs to specifically inhibit HCV translation. In addition, studies of interaction of hnRNPC1/C2 with HCV RNA and its re-localization upon HCV infection sheds light on the significance of host–virus interaction in viral RNA replication.

No description available.

La protéine NS5A est essentielle pour la réplication et l'assemblage du virus de l'hépatite C (VHC), et elle constitue une cible thérapeutique prometteuse pour le développement d'antiviraux. Cependant, aucune fonction claire n'a encore été décrite pour NS5A, et les connaissances structurales restent limitées. Ainsi, nous avons caractérisé l'état intrinsèquement désordonné des domaines D2 et D3 de NS5A en décrivant leurs espaces conformationnels et leurs potentialités de repliement en combinant différentes méthodes biophysiques. Nous avons aussi mis en évidence la variabilité structurale du domaine D2 au sein des génotypes du VHC, ce qui pourrait être en rapport avec les différences de pathogénie et d'efficacité des thérapies observées selon les génotypes. L'interaction de D2 et D3 avec la cyclophiline humaine A (CypA) a été étudiée par résonance plasmonique de surface (SPR). Bien que des mutations au sein du domaine D2 rendent la réplication du VHC moins dépendante de la présence de CypA, ces mutations n'empêchent pas la liaison entre D2 et CypA. En revanche, elles induisent des perturbations structurales qui pourraient affecter la cinétique d'interconversion des conformères de D2. Nous avons montré par SPR que D2 et D3 interagissent avec le domaine de fixation à l'ADN du récepteur nucléaire FXR. Cette interaction pourrait inhiber la fixation de FXR sur sa cible ADN, suggérant une implication de NS5A dans la modulation de l'activité transcriptionnelle de ce récepteur nucléaire. L'ensemble de ces informations, nous a permis de proposer un modèle de la structure globale de NS5A permettant une meilleure compréhension des propriétés structurales et fonctionnelles de cette protéine énigmatique / NS5A is essential for HCV replication and particle assembly, and constitutes a very promising drug target. However, no clear function has yet been described for NS5A, and structural knowledge remains limited. We characterized the intrinsically disordered nature of NS5A domains D2 and D3, and describe their folding propensity and their overall conformational behaviour by combining different biophysical methods. We also highlighted the structural variability of D2 domain in HCV genotypes, which might be correlated with the disparities observed between genotypes in terms of pathogenesis and efficiency of therapies. The interactions between D2 and D3 with human cyclophilin A (CypA) was analysed by surface plasmon resonance (SPR). We showed that mutations in the D2 domain conferring resistance of HCV replication to CypA inhibitors did not prevent the interaction between D2 and CypA. However, they induce structural perturbations that may affect the kinetics of conformers interconversion of D2. We also showed by SPR that D2 and D3 interact with the of DNA-binding domain of the nuclear receptor FXR (farnesoid X receptor alpha). This interaction reduce the binding of FXR to its DNA target, suggesting an involvement of NS5A in the modulation of the transcriptional activity of FXR. All this data led us to propose a model of the overall structure of NS5A, which provides a useful template for a better understanding of structural and functional properties of this enigmatic protein

Dans le monde, 58 millions de personnes sont chroniquement infectées par le virus de l'hépatite C (VHC). Depuis 2011, l'introduction des antiviraux à action directe a permis la guérison des infections chroniques chez la majorité des sujets traités (~95 %). Toutefois, les traitements sont coûteux et ne protègent pas contre les réinfections, d'où la nécessité de développer un vaccin prophylactique pour freiner efficacement l'épidémie du VHC. Environ 30% des primo-infections sont éliminées spontanément, représentant une occasion unique d'étudier les corrélats de l’immunité protectrice nécessaires pour le développement d’un vaccin efficace. Dans cette thèse, nous avons procédé à la définition des corrélats de l'immunité protectrice au cours des infections par le VHC primaires et subséquentes aux niveaux transcriptomique, clonotypique et fonctionnel à partir d’une cohorte d’utilisateurs de drogues par injection. Le premier objectif était de caractériser le répertoire de récepteurs des cellules T CD8 spécifique de l'épitope immunodominant et cross-réactif NS3 1073-1081 (CINGVCWTV) restreint par HLA-A2 au cours d’une primo-infection aiguë progressant vers une résolution spontanée ou une infection chronique. Nous avons identifié un ensemble de treize clonotypes publics, indépendamment de l'issue de l'infection. Plusieurs clonotypes publics avaient une longue durée de vie après résolution de l’infection et ont proliféré après réinfection par le VHC. En explorant les bases de données publiques, nous avons identifié plusieurs clonotypes partagés avec d'autres épitopes viraux restreints par HLA-A2, mais ils étaient de faible fréquence et de réactivité croisée limitée, suggérant un rôle limité des lymphocytes T CD8 cross-réactifs au cours de l'infection primaire par le VHC. Le deuxième objectif était de caractériser les signatures transcriptomiques longitudinales des cellules mononucléaires du sang périphérique totaux chez huit sujets ayant spontanément résolu deux infections consécutives par le VHC. Nous avons également comparé ces signatures avec un schéma vaccinal composé d'un vecteur à adénovirus de chimpanzé suivi d'un rappel utilisant la vaccine modifiée Ankara, exprimant tout deux les protéines non-structurales du VHC. Nous avons identifié une signature transcriptomique des plasmocytes au cours d'une réinfection aiguë, absente lors de l'infection primaire et après le rappel du vaccin. La résolution spontanée est associée à une expansion rapide des cellules B mémoires spécifiques de la glycoprotéine E2 chez 3 sujets et à une augmentation transitoire des anticorps neutralisants anti- E2 chez 6 sujets. Parallèlement, il y avait une augmentation de l'étendue et de l'ampleur des lymphocytes T spécifiques du VHC chez 7 sujets. En conclusion, nous avons identifié treize clonotypes publics uniques au VHC qui ont proliféré au cours des infections primaire et secondaire. La faible fréquence des clonotypes cross-réactifs suggère qu'ils ne sont pas des déterminants majeurs de l’issue de l’infection. De plus, nous avons observé une augmentation simultanée des réponses des lymphocytes B et T spécifiques du VHC au stade aiguë précoce, suggérant un rôle des deux bras de l’immunité adaptative dans la clairance de la réinfection du VHC. Nos résultats soutiennent l'idée de combiner deux stratégies vaccinales induisant à la fois une immunité à médiation cellulaire et une immunité humorale visant à prévenir les infections chroniques par le VHC. / Worldwide, 58 million individuals are chronically infected with hepatitis C virus (HCV). Since 2011, the introduction of direct acting antivirals enabled the cure of chronic HCV in the majority of treated subjects (~95%). However, direct-acting antivirals treatments are expensive and do not protect against reinfection, urging the need to develop a prophylactic vaccine to efficiently curb the HCV epidemic. Around 30% of acutely infected individuals will spontaneously clear the infection, representing a unique opportunity to study the correlates of immune protection needed to develop a potent vaccine. In this thesis, we proceeded to define the correlates of protective immunity during primary and sub-sequent HCV infections at the transcriptomic, clonotypic and functional levels using longitudinal peripheral blood mononuclear cells samples collected from a cohort of people who inject drugs (PWID). The first aim was to characterize the CD8 T cell receptor repertoire specific to the immunodominant and cross-reactive HLA-A2 restricted NS3 1073-1081 (CINGVCWTV) epitope during acute HCV in PWID progressing to either spontaneous resolution or chronic infection. We identified a set of thirteen public clonotypes in HCV-infected subjects irrespective of infection outcome. Several public clonotypes were long-lived in resolvers and expanded upon reinfection. By mining publicly available data, we identified several TCR clonotypes shared with other HLA-A2 restricted epitopes, but they were of low frequency and limited cross-reactivity, suggesting that they are not major determinants of infectious outcome. The second aim was to characterize longitudinal transcriptomic signatures using total peripheral blood mononuclear cells, as well as T and B cell recall responses in eight subjects who spontaneously resolved two successive episodes of HCV infection. Furthermore, we compared the transcriptomic signatures of primary and secondary resolving HCV infections, with an HCV nonstructural protein vaccine regimen of recombinant chimpanzee adenovirus 3 vector prime followed by modified vaccinia Ankara boost. We identified a plasma cell transcriptomic signature during early acute HCV reinfection that was absent in primary infection and following HCV vaccine boost. Spontaneous resolution of HCV reinfection was associated with rapid expansion of glycoprotein E2-specifc memory B cells in 3 subjects and transient increase in E2-specific neutralizing antibodies in 6 subjects. Concurrently, there was an increase in the breadth and magnitude of HCV-specific T cells in 7 subjects. In conclusion, we identified thirteen new public CD8+ TCR clonotypes unique to HCV that expanded during acute infection and reinfection. The low frequency of crossreactive TCRs suggests that they are not major determinants of infectious outcome. Moreover, we observed a concurrent increase of HCV-specific B and T cell responses early during acute HCV reinfection at the transcriptomic and functional levels, suggesting a role for both arms of the adaptive immune response in HCV reinfection clearance. Our results support the combined T and B cell-based vaccine strategy aimed at preventing chronic HCV infections.

La majorité des personnes utilisatrices de drogues par injection (PUDI) contracteront le virus de l’hépatite C (VHC), les mettant à risque accru de complications hépatiques graves et parfois mortelles. Les comportements les plus risqués pour l’acquisition du VHC incluent le partage de matériel d’injection et l’injection à haute fréquence. Un facteur jusqu’ici négligé dans l’évaluation du risque de VHC est l’aspect dynamique de l’injection, c.-à-d. la manière dont elle varie dans le temps, incluant l’effet des périodes sans injection et celui des changements dans la fréquence d’injection. On reconnaît également l’effet délétère que l’instabilité résidentielle peut avoir sur le risque de VHC, bien que les mécanismes sous-jacents soient mal compris. Cette thèse s’intéresse à l’effet des variations temporelles de l’injection sur le risque de VHC, et à la manière dont la fréquence d’injection évolue en concomitance avec les conditions résidentielles dans le temps, afin d’aider au développement de nouvelles stratégies de prévention du VHC. Les données ont été recueillies entre mars 2011 et juin 2016 dans la Hepatitis Cohort, une cohorte de PUDI suivies trimestriellement à Montréal, au Québec. Une première analyse a évalué l’effet des périodes sans injection de trois mois ou moins sur le risque de VHC sur 916 personnes-années de suivi, par régression de Cox (N=372). Celle-ci suggère que les PUDI présentant des périodes sans injection courtes (3/3 mois sans injection) et sporadiques (1/3 ou 2/3 mois sans injection) sont respectivement 76% et 44% moins à risque de VHC que celles s’injectant de manière persistante (0/3 mois sans injection). Une deuxième analyse a utilisé la modélisation de trajectoires fondée sur le groupement pour identifier cinq types distincts de trajectoires de fréquence d’injection suivies sur une année, lesquels ont ensuite été comparés en termes d’incidence du VHC sur des périodes de suivi allant de 71 à 355 personnes-années (N=386). Les résultats suggèrent que les PUDI dont la fréquence reste élevée (injection fréquente) ou change dans le temps (croissante, décroissante) sont à plus haut risque de VHC que celles s’injectant à basse fréquence (sporadique, peu fréquente). Une dernière analyse a identifié trois types de trajectoires de stabilité résidentielle suivies sur un an (persistance, déclin, amélioration; N=386), lesquels ont été évalués en association avec les trajectoires de fréquence d’injection suivies simultanément. Les résultats suggèrent qu’il existe un lien entre l’amélioration des conditions résidentielles et la diminution de la fréquence d’injection, mais aussi que la probabilité d’injection à fréquence croissante est plus élevée chez les PUDI maintenant des conditions résidentielles stables que celles chez qui elles s’améliorent. Collectivement, les résultats ont de nombreuses implications en termes de prévention du VHC. Cliniquement, l’instabilité de la fréquence d’injection semble être un facteur de risque à monitorer régulièrement. En termes de santé publique, les interventions favorisant l’engagement dans des périodes sans injection ou le maintien d’une basse fréquence d’injection pourraient être prometteuses. Enfin, les stratégies visant l’amélioration des conditions résidentielles pourraient éventuellement aider les PUDI à réduire leur fréquence d’injection, mais être insuffisantes pour maintenir celle-ci à basse fréquence une fois la stabilité atteinte. / The majority of people who inject drugs (PWID) will become infected with hepatitis C virus (HCV), placing them at risk of serious and sometimes fatal liver complications. Injecting behaviours with higher risk of HCV transmission include injecting equipment sharing and high frequency injecting. One factor that has been overlooked when assessing HCV acquisition risk is the dynamic aspect of drug injecting, i.e., how drug injecting varies over time, including the role of injecting cessation episodes and that of changes in injecting frequency. Moreover, there is growing recognition of the deleterious effect unstable housing can have on HCV acquisition risk, although the underlying mechanisms are not yet fully understood. This thesis examines how temporal variations in drug injecting relate to HCV acquisition risk and further explores how housing conditions and injecting frequency evolve together over time, for the purposes of contributing to the development of novel HCV prevention strategies. Data were collected between March 2011 and June 2016 in the Hepatitis Cohort, a prospective cohort study of PWID interviewed and tested for HCV infection at three-monthly intervals in Montréal, Québec. A first analysis examined the effect of injecting cessation episodes of three months or less on the risk of contracting HCV during 916 person-years of follow-up, using Cox regression (N=372). Results suggest that PWID with short injecting cessation episodes (3/3 months without injecting) or sporadic injecting cessation episodes (1/3 or 2/3 months without injecting) are 76% and 44% less at risk of contracting HCV than those with persistent injecting (0/3 months without injecting), respectively. A second analysis used group-based trajectory modeling to identify five distinct types of one-year injecting frequency trajectories and compared these in terms of HCV incidence over follow-up periods ranging from 71 to 355 person-years (N=386). Findings suggest that PWID injecting with consistently high frequencies (frequent) or time-varying frequencies (increasing, decreasing) are at greater HCV acquisition risk compared with those maintaining low injecting frequencies (sporadic, infrequent). Finally, a third analysis identified three types of one-year housing stability trajectories (sustained, declining, improving) and examined their associations with concomitant injecting frequency trajectories (N=386). Findings suggest an association between improving housing stability and decreasing injecting frequency, but also a higher probability of increasing injecting frequency among PWID who maintain housing stability compared to those that improve it. Collectively, these findings have numerous implications for HCV prevention. Clinically, instability in injecting frequency appears to be a risk factor that should be monitored regularly. From a public health perspective, interventions that promote engagement in injecting cessation episodes or maintenance of low injecting frequency may be promising. Finally, strategies aimed to improve housing stability may help PWID to decrease their injecting frequency but may not be sufficient to help them maintain low injecting frequencies once housing stability is achieved.

L’Organització Mundial de la Salut (OMS) estima que fins a un 3% de la població mundial ha estat infectada pel virus de l’hepatitis C i és la causa més important d’hepatitis crònica, cirrosi i de malaltia hepàtica terminal, que finalment acaba conduint a un transplantament de fetge. La relació entre la variabilitat en la seqüència del virus de l’hepatitis C i el desenvolupament de la malaltia hepàtica és de tipus multifactorial. La infecció crònica causa fibrosi hepàtica, fet que es veu accelerat per mecanismes desconeguts en el cas de pacients coinfectats amb VIH. La progressió de la malaltia produïda pel VHC en pacients coinfectats, està influenciada no només per factors demogràfics, epidemiològics o pels antecedents clínics dels pacients, si no també per diferències genètiques entre els diferents virus i els hostes.