Molecular Therapy: Nucleic Acids (Mar 2024)

Cytosine base editing inhibits hepatitis B virus replication and reduces HBsAg expression in vitro and in vivo

  • Elena M. Smekalova,
  • Maria G. Martinez,
  • Emmanuel Combe,
  • Anuj Kumar,
  • Selam Dejene,
  • Dominique Leboeuf,
  • Chao-Ying Chen,
  • J. Robert Dorkin,
  • Lan Shuan Shuang,
  • Sarah Kieft,
  • Lauren Young,
  • Luis Alberto Barrera,
  • Michael S. Packer,
  • Giuseppe Ciaramella,
  • Barbara Testoni,
  • Francine Gregoire,
  • Fabien Zoulim

Journal volume & issue
Vol. 35, no. 1
p. 102112

Abstract

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Chronic hepatitis B virus (HBV) infection remains a global health problem due to the lack of treatments that prevent viral rebound from HBV covalently closed circular (ccc)DNA. In addition, HBV DNA integrates in the human genome, serving as a source of hepatitis B surface antigen (HBsAg) expression, which impairs anti-HBV immune responses. Cytosine base editors (CBEs) enable precise conversion of a cytosine into a thymine within DNA. In this study, CBEs were used to introduce stop codons in HBV genes, HBs and Precore. Transfection with mRNA encoding a CBE and a combination of two guide RNAs led to robust cccDNA editing and sustained reduction of the viral markers in HBV-infected HepG2-NTCP cells and primary human hepatocytes. Furthermore, base editing efficiently reduced HBsAg expression from HBV sequences integrated within the genome of the PLC/PRF/5 and HepG2.2.15 cell lines. Finally, in the HBV minicircle mouse model, using lipid nanoparticulate delivery, we demonstrated antiviral efficacy of the base editing approach with a >3log10 reduction in serum HBV DNA and >2log10 reduction in HBsAg, and 4/5 mice showing HBsAg loss. Combined, these data indicate that base editing can introduce mutations in both cccDNA and integrated HBV DNA, abrogating HBV replication and silencing viral protein expression.

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