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The development of specific antiviral drugs directly targeting the hepatitis C virus (HCV) is clinically important, as the current standard interferon/ribavirin combination treatment is only partially effective, expensive and often associated with severe side effects. Inhibitors of the NS3 protease (PI) therefore represent a promising alternative or additional therapy. To date, the development and in vitro evaluation of PIs is restricted to the genotype 1/2 based replicon and the genotype 2a full length viral cell culture system. However, proteases of the different HCV genotypes vary substantially in their amino acid sequence and secondary structure and require separate evaluation of their efficacy before they go into clinical trials. To address this issue, a panel of intra- and intergenotypic recombinants based on the recombinant infectious clone Jc1 (pFK JFH1/J6/C-846) was developed in this work. The viability of these recombinants was assessed in the Huh7.5 cell culture system, where replicating viruses were detected by HCV-NS5A immunostaining. Intergenotypic recombinants containing genotype 1a, 1b, 3a, 4a and 6a derived proteases were replication defective, whereas the recombinant with genotype 5a derived protease replicated efficiently after acquiring cell culture adaptive mutations. The replacement of not only the NS3 protease gene region, but also its cofactor NS4A, allowed the generation of replication competent intra- and intergenotypic recombinants for all 6 major genotypes. Replacing the NS3 protease of the recombinants with that of patientderived proteases also generated replicating recombinants, greatly expanding the panel of intergenotypic recombinants available for phenotyping and PI evaluation. However, intra- and intergenotypic recombinants showed substantial differences in their replication kinetics, which may be influenced by naturally occurring polymorphism between genotypes and the differential requirement of adaptive/attenuating cell culture mutations. Genotype 1a recombinants replicated very poorly, which may be due to incompatibilities between the type 1a NS3/4A protease and the type 2a backbone. 50% inhibitory concentrations (IC50) of different PIs were measured using Foci Forming Units/ml (FFU/ml) reductions and replication inhibition assays. The different recombinants showed consistent, genotype-associated differences in their susceptibility to the PI BILN 2061, with genotypes 2a, 3a and 5a derived recombinants showing approximately 100-fold lower susceptibility than genotype 1b, 4a and 6a derived recombinants. These observations are consistent with major differences in response rates found in recent treatment trials of genotype 1, 2 and 3 infected patients. Differences in susceptibility were also observed for VX-950, with genotype 1b, 2a and 6a derived recombinants being twice as susceptible than genotype 3a, 4a and 5a derived recombinants. Passaging the intra- and intergenotypic recombinants under increasing concentrations of PI allowed the identification of PI resistance mutations. Resistance mutations to BILN 2061 mapped to the previously identified positions 156 and 168 within the NS3 protease, with a great diversity of amino acid substitutions observed within each genotype. Reintroduction of the identified resistance mutations into the original recombinant viruses conferred increased resistance towards BILN 2061 and some mutations also affected replication kinetics of the recombinants. The developed system will be of major value for the phenotypic characterisation of naturally occurring and treatment induced resistance mutations within all 6 major HCV genotypes towards different PIs. This will allow treatment response predictions for newly developed PIs before they enter clinical trials and the development of individually tailored antiviral treatment regimes.

AIM To evaluate magnitude/direction of changes in peripheral lipid profiles in patients undergoing direct acting therapy for hepatitis C by genotype. METHODS Mono-infected patients with hepatitis C were treated with guideline-based DAAs at a university-based liver clinic. Patient characteristics and laboratory values were collected before and after the treatment period. Baseline demographics included age, ethnicity, hypertension, diabetes, hyperlipidemia, treatment regimen, and fibrosis stage. Total cholesterol (TCHOL), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG), and liver function tests were measured prior to treatment and ETR. Changes in lipid and liver function were evaluated by subgroups with respect to genotype. Mean differences were calculated for each lipid profile and liver function component (direction/magnitude). The mean differences in lipid profiles were then compared between genotypes for differences in direction/magnitude. Lipid profile and liver function changes were evaluated with Levene's test and student's t test. Mean differences in lipid profiles were compared between genotypes using ANOVA, post hoc analysis via the Bonferroni correction or Dunnett T3. RESULTS Three hundred and seventy five patients enrolled with 321 (85.6%) achieving sustained-viral response at 12 wk. 72.3% were genotype 1 (GT1), 18.1% genotype 2 (GT2), 9.7% genotype 3 (GT3). Baseline demographics were similar. Significant change in lipid profiles were seen with GT1 and GT3 (Delta GT1, p and Delta GT3, p), with TCHOL increasing (+ 5.3, P = 0.005 and + 16.1, P < 0.001), HDL increasing (+ 12.5, P < 0.001 and + 7.9, P = 0.038), LDL increasing (+ 7.4, P = 0.058 and + 12.5, P < 0.001), and TG decreasing (-5.9, P = 0.044 and -9.80 P = 0.067). Among genotypes (Delta GT1 v.Delta GT2 v.Delta GT3, ANOVA), significant mean differences were seen with TCHOL (+ 5.3 v. + 0.1 v. + 16.1, P = 0.017) and HDL (+ 12.3 v. + 2 v. + 7.9, P = 0.040). Post-hoc, GT3 was associated with a greater increase in TCHOL than GT1 and GT2 (P = 0.028 and P = 0.019). CONCLUSION Successful DAA therapy results in increases in TCHOL, LDL, and HDL and decrease in TG, particularly in GT1/ GT3. Changes are most pronounced in GT3.

Diese Arbeit beschäftigt sich mit Zusammenhängen kognitiver Fähigkeiten und der Befindlichkeit bei Patientinnen mit Hepatitis C aus der sogenannten „Anti-D-Kohorte“. Die Frauen (n=2867) dieser spezifischen Gruppe wurden 1978/79 im Rahmen einer Anti-D-Immunprophylaxe mit dem Hepatitis C (1b) Virus infiziert. Häufig werden von Patienten, welche mit Hepatitis C infiziert sind, Beschwer-den wie Abgeschlagenheit, Ermüdung und Depressivität beklagt. In Studien wurden zudem Einschränkungen in der Kognition, insbesondere der Aufmerk-samkeit und des Gedächtnis festgestellt. Dazu wurden im Rahmen eines größeren Forschungsprojektes (Herzig et al in prep) 58 Hepatitis C Patientinnen und 25 gesunde Kontrollprobandinnen aus-gewählt. In dieser Arbeit werden die Ergebnisse der psychometrischen Testun-gen von Kognition und der Befindlichkeit vorgestellt und diskutiert. In den Komponenten Aufmerksamkeit und kognitive Flexibilität sowie in der Befindlichkeit konnten signifikante Unterschiede zur Kontrollgruppe nachgewiesen werden. Zudem fiel ein tendenzieller Vorteil antiviral therapierter Patientinnen und Patientinnen ohne nachweisbare Viruslast auf, sodass selbst HCV negative Frauen nicht als „gesund“ angesehen werden können und die Empfehlung zur medikamentösen Therapie aller viruspositiven Patientinnen besteht.

In der vorliegenden Arbeit wurden die Behandlungsabläufe von Patienten mit chronischer Hepatitis C unter Therapie mit Standard-Interferon (Kollektiv 1) bzw. mit pegyliertem Interferon (Kollektiv 2) ausgewertet. Die meisten Patienten erhielten eine Kombinationstherapie mit Ribavirin. Es bestand Strukturgleichheit für die Kollektive hinsichtlich Alter, Geschlecht, BMI vor Therapie, Übertragungsweg der Hepatitis, Hepatitis B-Infektion, HAI-Grading-Score und HAI-Staging-Score. Ein signifikanter Unterschied bestand für das Merkmal HIV-Koinfektion. Nach Therapiebeginn zeigte sich ein schnell einsetzendes serologisches und virologisches Ansprechen. Patienten unter Therapie mit pegyliertem Interferon und Ribavirin hatten die besten Chancen auf ein anhaltendes Therapieansprechen. Eine early virological Response war ein guter Prädiktor für das Erreichen einer sustained virological Response. Die meisten Patienten berichteten über Nebenwirkungen unter Therapie. Die häufigsten Nebenwirkungen waren Müdigkeit und Schmerzen, v.a. in Form von Kopfschmerzen. Diese kamen jeweils bei ca. 70% der Patienten vor. Eine Anämie trat bei ca. 9% der Patienten auf. Hämatokrit, Hämoglobin und Erythrozyten sanken im Kollektiv 2 stärker ab als im Kollektiv 1. Unter Kombinationstherapie mit Ribavirin sank das Hämoglobin zudem mehr ab als unter Interferon- Monotherapie, was auf den hämolytischen Effekt des Ribavirins zurückzuführen ist. Thrombozyten fielen unter Kombinationstherapie im Kollektiv 1 deutlich geringer ab als im Kollektiv 2, was durch einen stärkeren myelosuppressiven Effekt des pegylierten Interferons bedingt sein könnte. Im Kollektiv 1 sanken die Thrombozyten unter Monotherapie stärker ab als unter Kombinationstherapie. Leukopenien traten häufiger unter Therapie mit pegyliertem Interferon auf. Insgesamt zeigte sich im hier analysierten Kollektiv ein geringes Risiko für eine Neutropenie oder Lymphopenie. Vor allem ältere Patienten mit niedrigen neutrophilen Granulozyten bzw. Lymphozyten vor Therapie schienen ein erhöhtes Risiko für eine Neutropenie bzw. Lymphopenie zu haben. Das Therapieansprechen und die Therapiedauer waren für Patienten mit bzw. ohne Leukopenie, Neutropenie oder Lymphopenie ähnlich. Für Infektionen fand sich ebenfalls kein signifikant erhöhtes Risiko bei Patienten mit Leukopenie, Neutropenie oder Lymphopenie. 16% der Patienten im Gesamtkollektiv hatten eine Infektion unter Therapie. Es zeigte sich kein Unterschied zwischen Kollektiv 1 und 2 für Infektionen unter Therapie. Patienten mit bzw. ohne Infektion wurden hinsichtlich der Merkmale Alter, Geschlecht, BMI, Hepatitis B-Infektion, Hepatitis G/GB-Infektion und HIV-Infektion verglichen. Zudem wurden die prätherapeutischen Laborwerte Ferritin, Viruslast, Eisen, TSH, GPT, GOT, Hämoglobin, Hämatokrit, Leukozyten, neutrophile Granulozyten, Lymphozyten, Thrombozyten und Erythrozyten gegenübergestellt und Therapiedauer und Therapieansprechen für Patienten mit bzw. ohne Infektion erhoben. Für keines dieser Kriterien lag ein signifikanter Unterschied zwischen Patienten mit Infektion und Patienten ohne Infektion vor. Die meisten Infektionen waren unkomplizierte, respiratorische Infektionen. Diese traten für Patienten mit Neutropenie und Patienten ohne Neutropenie gleich häufig auf. HIV-Patienten hatten ein höheres Infektionsrisiko. Jedoch war der Unterschied nicht signifikant. Beim Vergleich des prozentualen Absinkens der Lymphozyten vom Ausgangswert zeigte sich ein schwach signifikanter Unterschied zwischen den Werten zu Infektionszeitpunkten und den Werte für Patienten ohne Infektion. Für die absoluten Werte war der Unterschied nicht signifikant. Für neutrophile Granulozyten und Leukozyten fanden sich keine Unterschiede zwischen den Werten für Infekt-Patienten zum Infektionszeitpunkt, den Werten zu infektfreien Zeitpunkten und den Werten für Patienten ohne Infektion. Insgesamt fand sich im hier untersuchten Kollektiv keine Assoziation von Infektionen unter Interferontherapie mit Leukopenien oder Neutropenien. Ein Absinken der neutrophilen Granulozyten scheint daher in größerem Maße ohne Dosisreduktion tolerierbar zu sein als bisher empfohlen. Ein relativer Lymphozytenmangel könnte mit dem Auftreten von Infektionen assoziiert sein. Für den absoluten Lymphozytenmangel fand sich diese Assoziation jedoch nicht. / In the present study, the treatment procedures for patients with chronic hepatitis C during therapy with standard interferon (group 1) or with pegylated interferon (group 2) were evaluated. Most patients received combination therapy with ribavirin. It was par for the collective structure in terms of age, gender, BMI before therapy, transmission of hepatitis, hepatitis B infection, HAI grading and staging score. A significant difference was found for the characteristic HIV co-infection. After starting therapy a rapid onset of serological and virological responses was seen. Patients treated with pegylated interferon and ribavirin had the best chances of sustained response to therapy. An early virological response was a good predictor of sustained virological response. Most patients reported side effects during treatment. The most common side effects were fatigue and pain (both for about 70% of patients), especially in the form of headache. Anaemia occurred in approximately 9 % of patients. The decreases of hematocrit, hemoglobin and erythrocytes was stronger in group 2 than in the first group Under combination therapy with ribavirin hemoglobin decreased also stronger than under interferon monotherapy, which is due to the haemolytic effect of ribavirin. On combination therapy in group 1 platelets were significantly lower than in group 2, which could be due to a greater myelosuppressive effect of pegylated interferon. In group 1, the platelets decreased stronger under monotherapy compared with combination therapy. Leukopenia occurred more frequently during treatment with pegylated interferon. Overall, the analyzed risk of neutropenia and lymphopenia in this collective was small. Especially elderly patients with low neutrophil granulocytes or lymphocytes before starting therapy seemed to have an increased risk for neutropenia and lymphopenia. The treatment response and duration of therapy were similar for patients with or without leukopenia, neutropenia and lymphopenia. There was also no significant increased risk for infections in patients with leucopenia, neutropenia and lymphopenia. 16 % of patients in the total group had an infection during treatment. There was no difference between the collective 1 and 2 for infections during treatment. Patients with and without infection were compared for age, gender, BMI, hepatitis B infection, hepatitis G / GB-infected and HIV-infection. In addition, the pretherapeutic laboratory values ferritin, viral load, iron, TSH, ALT, AST, hemoglobin, hematocrit, leukocytes, neutrophils, lymphocytes, platelets and red blood cells, treatment duration and response rate were compared for patients with and without infection. For none of these criteria a significant difference between patients with infection and patients without infection was found. Most infections were uncomplicated respiratory infections. These occurred equally in patients with neutropenia and patients without neutropenia. HIV patients had a higher risk of infection. However, the difference was not significant. Comparing the percentage drop in the lymphocytes from baseline a weak significant difference was shown between the values at infection times and the avarage values for patients without infection. For the absolute values the difference was not significant. For neutrophils and leukocytes, there were no differences between the values for patients at times of infection, the values at infection-free times and the values for patients without infections. In total no association of infection with interferon therapy with leukopenia or neutropenia was found. A decrease in neutrophils seems therefore to be more tolerable without dose reduction than recommended till now. A relative lack of lymphocytes could be associated with the occurrence of infections. For the absolute lymphocyte deficiency this association was not found.

There are an estimated 350 million people chronically infected with Hepatitis B Virus (HBV), of which approximately 600 000 die each year from HBV complications including cirrhosis and liver cancer. The X protein from HBV (HBx) has been implicated in the progression of chronic HBV to liver cancer and has been reported to manipulate several critical cellular pathways. These include the cell cycle, the tumour suppressor protein p53, protein degradation and signal transduction pathways. The role of these interactions in HBV replication and the viral lifecycle is currently unknown. The lack of animal models and infectable cell lines together with solubility and stability issues related to the HBx protein have made progress difficult. The reliance on approximate cellular and animal models has yielded many discordant studies that have confounded our interpretations of the role of HBx. There have been no novel approaches attempting to express HBx at a quantity and quality sufficient for high resolution X-ray and nuclear magnetic resonance structural determination. Additionally no bioinformatic analyses have been applied to HBx, and thus distinctive features of HBx that may be responsible for these challenges have not been reported. This thesis describes the detailed experimentation to express and purify HBx in a functional, soluble and stable form. The study focussed on Saccharomyces cerevisiae and Semliki Forest Virus (SFV) expression systems, together with the use of a solubility-enhancing Maltose Binding Protein protein tag (MBP). The S. cerevisiae-based pYES2 and YEp and mammalian expression vectors showed production of HBx protein. However HBx that had been expressed using S. cerevisiae and human cells could not be reliably detected in Western blots using antibodies raised against E. coliexpressed HBx. This result was despite the positive visualisation of HBx using the same antibodies and immunofluorescence microscopy. This validated previous reports describing the variable antigenicity of HBx. Furthermore these findings supported the decision to develop eukaryotic-based HBx expression vectors as results suggested structural differences between eukaryote and prokaryote expressed protein. HBx was subsequently detected and purified in a soluble and active form using an MBP tag as well as a SFV expression vector. All of these options provide an excellent point from which further work at optimising HBx expression and structural elucidation can occur. Bioinformatic analysis of HBx suggested the presence of protein disorder and protease sensitive sites within the negative regulatory domain of HBx. Literature descriptions of the molecular promiscuity that protein disorder allows, offers an explanation for the presence of the discordant findings on HBx interactions and functions. It is generally accepted that proteins containing disorder are tightly regulated and thus experimental systems employing overexpression methodologies may encourage cellular toxicity and non-specific interactions through the use of short linear motifs. Evolutionary analysis of HBx sequences revealed that the eight HBV genotypes (A-H) showed concordance regarding synonymous and non-synonymous substitutions at the overlapping and non-overlapping domains of hbx. Substitutions in hbx were most common at positions where a synonymous substitution occurred in the overlapping partner gene. The presence of sites under positive, neutral and negative selection were identified across the length of HBx. The different genotypes showed positive selection indicating selective pressures unique to each, thus offering a contributing explanation for the variable disease severity observed between the subtypes. Overall, this thesis has provided novel methods to express and purify HBx in S. cerevisiae and mammalian cells. These methods, together with an increased understanding of the nature of HBx sequences through bioinformatic analysis, pave the way to conduct both structural studies and biological assays to elucidate the genuine roles of HBx in the HBV lifecycle and its contribution to the progression to liver cancer.

Hepatitis B virus (HBV) is a major global public health burden, with over 350 million people chronically infected. This results in approximately 600,000 liver cancer-related deaths annually. Chronic HBV infections are normally managed with long-term anti-HBV therapeutics, such as reverse transcription inhibitors, which target post-transcriptional viral processes without affecting the cccDNA. Treatment failure however is largely as a result of the stability of this episomal viral DNA. The cccDNA minichromosome serves as a reservoir of HBV DNA and is capable of re-establishing viral replication following withdrawal of treatment. Designer nucleases, like transcription activator-like effector nucleases (TALENs), have recently been used to create double stranded breaks (DSBs) at target-specific endogenous DNA loci. These nucleases are designed as pairs, which upon dimerisation cleave double-stranded DNA. Subsequent activation of the cellular non-homologous end-joining (NHEJ) pathway often results in targeted mutagenesis at the DSB site. As TALENs may be designed to bind to any DNA sequence, they are commonly used as genetic engineering agents. Inactivation of HBV cccDNA, using these engineered TALENs, presents a unique approach to disabling viral replication permanently. To investigate this, a panel of TALENs targeting the core (C), surface (S) and two different polymerase (P1 and P2) regions of HBV cccDNA were generated using a Golden gate modular assembly approach. TALENs were initially tested in two liver-derived cell lines. Firstly as transient co-transfections in Huh7 cells using a HBV replication competent plasmid, followed by long term investigations in HepG2.2.15 cells which model HBV replication in vitro. Inactivation of HBV was determined by measuring markers of viral replication, whilst TALEN-mediated targeted disruption was verified by T7 endonuclease 1 (T7E1) or CELI endonuclease assays and sequencing. In vitro, the S TALEN inhibited HBsAg secretion by 80% in Huh7 cells and 60% in HepG2.2.15 cells. Furthermore, S TALEN-mediated targeted disruption occurred in 35-47% of cccDNA copies, whilst the C TALEN resulted in 11% targeted disruption of cccDNA in without inhibition of HBsAg expression. The P2 TALEN showed no anti-HBV efficacy, however the P1 TALEN inhibited HBsAg expression by up to 60% without any evidence of site-directed cleavage. As this TALEN binding site spans the HBV Enhancer I sequence, knock-down of HBsAg expression is most likely to occur as a result of transient transcriptional repression. To confirm whether permanent repression of HBV transcription could be achieved, a KRAB-based transcription activator-like repressor (rTALE) targeting the HBV pre-S2 promoter was generated. Using an in vitro reporter gene assay, the pre-S2 rTALE inhibited luciferase expression by up to 90%. However this was only achieved using high molar concentrations of the repressor, suggesting multiple rTALEs may improve HBV transcriptional repression. As the S and C TALENs displayed significant anti-HBV efficiency in vitro, they were tested in a murine hydrodynamic injection model of HBV replication. In vivo, the S TALEN inhibited HBsAg secretion by 95% and induced disruption in 77–87% of HBV DNA targets. In addition the C TALEN inhibited HBcAg expression and induced disruption in 78-93% of HBV DNA targets. Additionally, serological analysis showed a reduction in circulating virions and no apparent liver toxicity, as determined by real-time PCR (qPCR) and aspartate transaminase (AST)/ alanine aminotransferase (ALT) liver function tests respectively. Deep sequencing at the S and C TALEN binding sites showed targeted mutagenesis of HBV DNA in samples extracted from murine hepatocytes transfected with TALENs, however wild-type sequences were exclusively detected in mice that had not been treated with anti-HBV TALENs. Furthermore, frameshift deletions were predominantly detected indicating major disruptions in the HBV surface and core sequences. These results indicate that TALENs designed to disable and silence HBV cccDNA are effective both in vitro and in vivo and as such provide a promising therapeutic approach to treat this serious infection.

PhD, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Chronic infection with the hepatitis B virus (HBV) is a major risk factor for cirrhosis and hepatocellular carcinoma, which is the sixth most common cancer worldwide. Available treatment for chronic HBV infection has limited efficacy in preventing associated complications. The compact and multifunctional nature of the viral genome limits its mutability making HBV an ideal candidate for therapy based on nucleic acid hybridisation. The potent and specific gene silencing that can be achieved with RNA interference (RNAi) has fueled interest in exploiting this pathway as a therapeutic modality. Synthetic and expressed RNA sequences have been used to activate RNAi. These engineered sequences mimic natural substrates of the RNAi pathway, which allows them to enter and reprogramme the pathway to effect silencing of intended targets. Tradionally expressed RNAi activators have been transcribed as short hairpin RNA (shRNA) sequences from RNA polymerase III (Pol III) promoters. These shRNA mimic precursor microRNA (pre-miRNA) and consequently enter the RNAi pathway at a relatively late stage. Overexpression of shRNA sequences from Pol III promoters, specifically the U6 promoter, has been associated with toxic side effects and has raised concerns about the use of expressed RNAi activators. Another concern of developing therapeutic RNAi expression cassettes is the emergence of HBV mutants that are resistant to silencing by a single expressed RNAi effecter. These points have highlighted the need for the development expressed RNAi activators that are effective at low concentrations and capable of combinatorial silencing. To address these issues the aim of this study was to assess the feasibility of anti HBV effecter sequences that mimic an early substrate (viz. primary miRNA or pri-miRNA) of the RNAi pathway. Pri-miRNA expression is typically under the transcriptional control of Pol II promoters. Consequently RNAi activators that Abstract - xi - mimic pri-miRNA, so-called pri-miR shuttles, may be expressed from Pol II promoters. Initially a panel of shRNA expression cassettes driven by a Pol III promoter was constructed and silencing of HBV replication assessed. Pri-miR shuttles were then designed by incorporating guide sequences of the most effective anti HBV U6 shRNA into naturally occurring pri-miR-122 and pri-miR-31. Potent inhibition of viral replication was observed with both Pol III and Pol II-driven pri-miR shuttle expression cassettes in vitro and in vivo. Subsequently liver-specific pri-miR-122 and multimeric pri-miR-31 shuttle expression cassettes were created. Pri-miR-122 shuttle sequences expressed from the alpha-1 antitrypsin promoter and HBV basic core promoter exhibited the best liver-specific silencing. Polycistronic pri-miR-31 shuttle sequences were shown to produce multiple RNAi activators capable of silencing multiple target sequences. Silencing by the pri-miR shuttle sequences was independent of toxic effects that arise from induction of the interferon response or saturation of the endogenous miRNA pathway. Pri-miR shuttles clearly represent an improved option for the use of expressed shRNA and brings therapeutic RNAi technology a step closer to clinical application.

MSc (Med), Faculty of Health Sciences, University of the Witwatersrand / The hepatitis B virus remains a major public health problem even after decades of its discovery. Horizontal transmission during early childhood is the predominant mode of transmission in highly endemic regions such as sub-Saharan Africa. Infection exhibits a wide spectrum of clinical manifestations, from an asymptomatic stage to severe liver disease which may result in hepatocellular carcinoma (HCC). The HBV X protein (HBx) has been implicated in carcinogenesis, which often has a poor prognosis, consequently the use of highly specific monoclonal antibodies (mAbs) directed against HBx in an enzyme-linked immunosorbent assay (ELISA) could lead to early identification of HBV carriers at risk of developing liver cancer. A variety of mixed hybridoma cell cultures secreting anti-HBx antibodies were cloned and sub-cloned by “limiting dilution”. Clonal supernatants were assessed for anti-HBx antibody production by Indirect ELISA and Western/Immunoblotting. Monoclonal antibodies were then characterized according to their relative binding affinity (Indirect ELISA) and relative epitope specificity (Competitive ELISA). One of our monoclonal antibodies was found to bind to the same epitope on HBx as the commercial anti-HBx antibody and with the same high affinity. In the developed Sandwich ELISA, our monoclonal antibody proved effective as the „detecting‟ antibody when the commercial anti-HBx antibody was deployed as the „capture‟ antibody. This Sandwich ELISA will be further developed in our laboratory with the object of applying it to patient sera.

Degree awarded with distinction on 6 December l995. A dissertation submitted to the Faculty of Science, University the Witwatersrand, in fulfilment of the requirements for the degree of Master of Science. March. 1995 / Hepatitis B virus (HBV) infection resulting in integration of the viral DNA into host liver cell DNA is associated with the development of hepatocellular carcinoma (HCC). This is indicated by epidemiological trends, molecular studies and studies of animal models infected with viruses closely related to HBv. However, little is known about the mechanism by which the integrated HBV DNA includes HCC despite continuing analysis of the integrated HBV DNA and its surrounding cellular sequences. [Abbreviated Abstract. Open document to view full version]