Antiviral Research

Defective interfering particles (DIPs) derived from the influenza A virus (IAV) are a promising antiviral agent due to their strong antiviral efficacy demonstrated in various animal models. OP7 is an unconventional IAV DIP with multiple point mutations in the viral RNA (vRNA) of genome segment 7, as opposed to the large internal genomic deletions typically found in conventional IAV DIPs. Further, OP7 showed an even higher interfering efficacy than conventional DIPs. However, the inhibitory effect of OP7 on standard virus (STV) replication has primarily been investigated in Madin-Darby Canine Kidney (MDCK) cells, which lack a functional myxovirus resistance (Mx)-mediated antiviral activity against IAV. In this study, we examined the antiviral activity and mechanism of antiviral action of OP7 in an interferon (IFN)-competent human lung carcinoma cell line (Calu-3) in vitro. We performed STV and OP7 co-infection experiments using a variety of infection conditions and measured the time-resolved dynamics in viral titer, vRNA, protein level, and host cell gene expression. We observed that OP7 co-infection results in enhanced type I IFN responses and markedly reduced infectious virus release, even at low doses. Additionally, we found that at a high STV multiplicity of infection (MOI), the replication interference of OP7, suppressing the replication of STV vRNA, appears to be the dominant mechanism of its antiviral action. At a low MOI, however, IFN induction seems to be more important. Furthermore, we examined the efficacious co-infection time window for potential prophylactic and therapeutic antiviral treatment. We observed an antiviral effect exerted by OP7 infection for up to seven days before STV infection and up to 24 hours after STV infection. Together, these findings demonstrate that OP7 is a potent antiviral DIP. Therefore, this work supports the further development of OP7 as a therapeutic and prophylactic antiviral agent.

Cell cycle manipulation is critical to oncogenesis, including cancers associated with oncogenic gammaherpesviruses, Epstein-Barr Virus and Kaposis Sarcoma-associated Herpesvirus. Infection with these viruses can result in various cancers, including lymphomas and carcinomas. In healthy individuals, gammaherpesvirus infections result in lifelong latent infections with occasional reactivation. The cell cycle plays a critical role in infection, particularly in reactivation from quiescent latency to lytic virus replication. A number of cyclin-dependent kinase (CDK) inhibitors are clinically available but with little investigation thus far for virus-associated cancers. Using the mouse gammaherpesvirus model, we assessed the impact of CDK inhibitors on virus reactivation. First, we tested chemical inducers of reactivation, and found that optimal reactivation occurred with a combination of PMA and sodium butyrate. Application of optimal reactivation triggers demonstrated distinct stage-specific outcomes of reactivation, distinguished using flow cytometry to measure expression of GFP (early reactivation) and vRCA, a late viral protein (late reactivation). Following chemical induction of reactivation, we used flow cytometry to demonstrate that the early effects of induction were unaffected by CDK inhibitors. However, all broad spectrum CDK inhibitors tested, Dinaciclib, Alvocidib, and Seliciclib, decreased both reactivation from latency and primary lytic replication. In contrast, the impact of targeted CDK 4/6 inhibitors, Palbociclib, Ribociclib, and Abemaciclib, was more nuanced, with decreased reactivation when given concurrently, but increased reactivation when administered prior to induction. These findings were consistent for both murine gammaherpesvirus and Epstein-Barr Virus. Overall, our data indicate that CDK inhibitors may be useful for targeted treatment of gammaherpesvirus-associated cancers, but optimal use of targeted CDK 4/6 inhibitors requires careful consideration of cell state and order of therapies.

The influenza virus poses a significant global health threat due to its continuous evolution, immune evasion, and zoonotic spillover. The rise of drug resistance, reduced susceptibility to existing antiviral medications, and the limited effectiveness of annual vaccines underscore the need for new antiviral strategies. To infect, the influenza virus binds to sialic acid (SA)-containing molecules on host cell membranes through hemagglutinin (HA). Blocking this interaction represents a promising antiviral approach. Herein, we report that SA containing plasma membrane-derived vesicles (PMV) efficiently inhibits in vitro Influenza A virus (IAV) infection. Using orthogonal methods, we demonstrate that PMV derived from A549, MDCK, and HEK cells competitively bind to H1N1 (WSN) and H3N2 (X-31) IAV strains, block entry and infection in human respiratory epithelial cells in a dose-dependent manner, without causing significant toxicity. When the size of the vesicles was reduced through extrusion, the antiviral activity was enhanced, and this was found to be correlated with a size-dependent increase in hemagglutination inhibition and reduced IAV internalisation. Plasma membrane-derived vesicles may serve as a novel antiviral strategy against influenza virus infections due to their simple production method and conserved SA binding site on HA.

In an infection, Hepatitis B Virus (HBV) core protein (HBc) normally assembles into icosahedral capsids. Capsid Assembly Modulators (CAMs) are direct acting antivirals that induce HBc mis-assembly and are the subject of active research and development. Two versions of HBc are used in structural studies of CAM-HBc complexes: Cp150 and Cp149-Y132A. Cp150 forms empty icosahedral capsids that are structurally indistinguishable from those found in virions. The Y132A mutation of Cp149 leads to an assembly defective soluble protein that crystalizes as flat hexagonal sheets, where the hexagons resemble icosahedral quasi-sixfold vertices. In this study, we compare structures of CAM-bound Cp150 to CAM-bound Cp149-Y132A. In capsids, the residues forming the CAM site shift to match the structure of bound CAMs, an induced fit. In Cp149-Y132A crystals, CAM sites show little structural adjustment in response to different CAMs binding. In turn, the array of residues that interact with CAMs varies from CAM to CAM in capsid structures but remains nearly constant in Cp149-Y132A crystals. These results illustrate important differences between CAM binding in Cp149-Y132A and Cp150 structures that will contribute to future CAM design.

We prepared siRNA libraries against the H5N2 virus NP gene, and the PA, PB1 and PB2 genes that express the proteins that form the virus polymerase complex. The antiviral activity of the siRNA libraries in H5N2 virus infected cells was initially assessed by using qPCR to measure the corresponding mRNA levels in the siRNA-treated cells. In this way siRNA molecules within each library were identified that exhibited to a greater than 70% reduction in levels of each target mRNA. A selection of these siRNA molecules was further evaluated for their antiviral activity in a multi-cycle H5N2 MDCK cell model. The siRNA molecules identified were successful in blocking virus transmission and lead to a reduction in influenza virus progeny virus production. This antiviral activity correlated with both the inhibition of nuclear export of the newly formed RNP complexs that arise from the transcriptional activity of the input virus, and the inhibition of the polymerase activity of the newly formed virus polymerase complexes. This study highlights the potential use of siRNA as a strategy to block virus transmission by targeting the avian influenza virus polymerase complex.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are key components of combination antiretroviral therapy (ART) for the treatment of human immunodeficiency virus type 1 (HIV-1) infection, binding an allosteric pocket of reverse transcriptase (RT) and inhibiting viral replication. Although second-generation NNRTIs have improved potency and resistance profiles compared to first-generation NNRTIs, the continued emergence of resistant viral strains and the need for long-acting therapeutic options underscore the importance of developing next-generation compounds. Depulfavirine (VM1500A) is a potent NNRTI being developed as a long-acting formulation. Its prodrug, elsulfavirine (ESV), is approved for HIV-1 treatment in Eurasian countries as a once-daily oral regimen and has demonstrated favorable antiviral efficacy, pharmacokinetics, and tolerability in clinical studies. Here, we report the 2.4 [A] crystal structure of HIV-1 RT in complex with depulfavirine, revealing an extended binding conformation within the NNRTI pocket that reaches from the back of the binding pocket to the entrance. These interactions may shed light on mechanisms of resistance to the F227C mutation, with and without V106 substitution, and Y188L. Notably, depulfavirine maintains potent inhibition of common NNRTI-resistant RT variants, including K103N and Y181C. Combination studies of ESV with antivirals from diverse inhibitor categories demonstrated additive or near-synergistic activity with islatravir (ISL), cabotegravir (CAB), lenacapavir (LEN), and tenofovir (TDF). These findings highlight the broad resistance profile and potential of the depulfavirine combination.

Oncolytic virotherapy is an emerging cancer therapy using genetically modified viruses. We previously reported engineering of measles virus with BNiP3, a proapoptotic gene for oncolytic purposes. The recombinant virus had shown promising results in breast cancer cells with a bias towards TNBC, an invasive and an aggressive subtype. Here, we investigated the mechanistic insights of anti-tumor effects induced by the recombinant virus. Initially, TNBC and non-TNBC tumor cell lines were compared bioinformatically using the available gene expression data through protein-protein interaction network using different topological properties. Four hub genes involved in tumor development and progression were identified to be the top genes in both the data sets. Of which, CTNNB1 gene encoding {beta}-catenin was found to be the significant one; as {beta}-catenin pathway is known to be a driver of tumor cell invasion and migration, the impact of the virus on this pathway was investigated in breast tumor cells. The results had demonstrated a notable decrease in {beta}-catenin expression and its downstream targets, cyclin D1, MMP7 reducing the migration potential of TNBC cells following virus infection. These findings suggest that the recombinant measles virus could be one of the effective treatment modalities to target invasive TNBC tumors. In vivo validation of engineered virus is ongoing to explore the therapeutic application of this virus. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=126 SRC="FIGDIR/small/718830v1_ufig1.gif" ALT="Figure 1"> View larger version (57K): org.highwire.dtl.DTLVardef@19d321dorg.highwire.dtl.DTLVardef@1450ebeorg.highwire.dtl.DTLVardef@cb191eorg.highwire.dtl.DTLVardef@1de2d16_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LIUse of recombinant measles virus with a pro-apoptotic gene, BNiP3 to target breast cancer cells C_LIO_LIIdentification of top regulatory genes in breast cancer development and progression C_LIO_LIReduction of {beta}-catenin expression encoded by CTNNB1 gene in TNBC cells following virus infection C_LIO_LIDownregulation of {beta}-catenin downstream targets in TNBC cells with virus infection C_LIO_LIInhibition of migratory potential of TNBC cells following infection C_LI

Host-targeting antivirals offer a promising strategy for combating emerging viral threats by targeting cellular pathways required for infection. The p38 mitogen-activated protein kinase (MAPK) pathway has been implicated as a host dependency factor exploited by multiple viruses, including coronaviruses, making it an attractive antiviral target. Here, we show for the first time that targeted degradation of p38 using the proteolysis-targeting chimera (PROTAC) NR-7h potently inhibits coronavirus infection. NR-7h induced substantial degradation of p38 in multiple cell lines and inhibited infection of two seasonal coronaviruses OC43 and 229E, providing broad pan-coronavirus activity. Infectious viral titres and viral RNA levels were significantly reduced without any detectable cytotoxicity. NR-7h exhibited greater antiviral potency than conventional p38 small-molecule inhibitors, with an IC50 of 1.0 nM compared with 648.4 nM for LY2228820, while the parent kinase inhibitor PH-797804 did not achieve 50% inhibition at the highest concentration tested. Pseudovirus and time-of-addition studies indicated that antiviral activity occurred at a post-entry stage of infection. Importantly, antiviral activity was eliminated by inhibition of proteasome function or E3 ligase activity, demonstrating dependence on PROTAC-mediated degradation. Our findings provide a proof-of-concept that targeted degradation of host kinase p38 can function as an antiviral modality and suggest PROTAC-based host-directed therapeutics may offer advantages over conventional kinase inhibition for broad-spectrum antiviral development.

The ubiquitin-conjugating enzyme UBE2J1 functions in the proteasomal degradation of proteins at the ER. Existing evidence suggests that it plays a role during viral infection, with elevated UBE2J1 levels generally associated with increased infection. This is particularly relevant for some RNA viruses; however, the regulation of UBE2J1 during infection has not been well studied. Here, we used a BHK21 cell model to demonstrate that UBE2J1 overexpression promotes the replication of Vesicular Stomatitis Virus (VSV), as indicated by a significant increase in viral titres. To better understand the underlying molecular processes, cells were co-transfected to express the VSV-G protein and wild-type UBE2J1 protein, and we observed a significant increase in the syncytial fusion area. This effect was not observed when catalytically inactive (C91S) or phospho-deficient (S184A) forms of the protein were used. Interestingly, overexpression of a truncated, non-ER localized form of UBE2J1 ({Delta}TM) led to the largest increase in the syncytial fusion area. This arose as a result of increased syncytia size, and may indicate an enhanced cellular role if soluble forms of UBE2J1 are not anchored to the ER. Additional studies using truncated, mutated and wild-type proteins confirmed that UBE2J1 increases VSV viral replication and is associated with an increase in the number of infection plaques. Considering the emerging evidence for UBE2J1 involvement in viral infection, our finding should help in understanding the role of this protein in viral pathogenesis and cellular processes linked to syncytialization.

The caliciviruses include important human and animal pathogens such as norovirus, sapovirus and feline calicivirus. Viral reverse genetics is performed to understand the fundamental biology of these viruses, as well as a potential route to generate live-attenuated vaccines. Calicivirus reverse genetics systems have typically relied on either on the production of in vitro-transcribed RNA or plasmid-based rescue either from a mammalian promoter, or through supplementing with helper enzymes through means of a helper virus. Here, we present a novel system integrating vaccinia capping enzymes D1R and D12L encoded on plasmids as part of a system for Murine Norovirus (MNV) reverse genetics. Addition of D1R, D12L and T7 RNA polymerase-expressing plasmids increases the viral titres of rescued MNV in both BSR-T7 cells and transgenic BSR-T7CD300LF cells, and viral polyprotein abundance. When the murine norovirus receptor is expressed in BSR-T7CD300LFcells, viral titres increased 100-1000-fold compared over standard BSR-T7 cells. This system offers a robust, high-throughput means of assessing viral mutants.

Recently Hariharan et al.2 reported naturally arising defective HIV genomes capable of conditional replication and interference in humans. While this work makes an important contribution to the field of therapeutic interfering particles (TIPs), particularly with respect to safety and tolerability, it also raises fundamental issues regarding: (i) whether the presented data constitute a valid test of, or support conclusions about, the therapeutic potential of TIPs and (ii) technical issues pertaining to the reported basic reproductive numbers (R0). Hariharan et al. conclude that the findings "raise concerns about the effectiveness of TIPs." However, the data presented do not constitute a valid test of therapeutic efficacy. Here, we (i) clarify that post-hoc observational natural history cannot adjudicate the success or failure of an intervention, (ii) show new analysis highlighting how the reported R0 measurements are internally inconsistent with the within-host viral dynamics reported, and (iii) explain that alternative, well-established mechanisms remain sufficient to explain the reported observations.

Exacerbations of respiratory viral infections significantly contribute to morbidity and healthcare burden. Among these viruses, Human Rhinoviruses (HRVs) are the most frequent causative agents of upper respiratory tract infections. To date, over 150 HRV serotypes have been identified, classified into three species: HRV-A, HRV-B, and HRV-C. No antiviral therapies are currently available against this viral family, largely due to the high serotype diversity and limited cross-protection. The major group of HRVs relies on the Intercellular Adhesion Molecule-1 (ICAM-1) receptor to infect airway epithelial cells, making ICAM-1 an attractive target for broad-spectrum therapeutic interventions. Here, we report the development of nucleic acid-based aptamers designed to disrupt ICAM-1-HRV binding and thereby prevent viral infection. Aptamers are single-stranded DNA molecules that fold into precise three-dimensional structures, enabling highly specific protein recognition. Using a Systematic Evolution of Ligands by EXponential Enrichment (SELEX) approach guided by a minimal peptide mimicking the ICAM-1 viral binding interface, a library of >1024 random single-stranded DNA sequences was screened. Through iterative rounds of selection, we identified eight candidate 77-nt DNA aptamers, which were subsequently evaluated for their potential using in silico and in vitro assays, as well as functional assays in human epithelial cells. From this strategy, two lead aptamers were selected that effectively inhibited HRV-A16 replication in a concentration-dependent manner, as measured by viral titers (TCID assay) and viral RNA quantification by RT-PCR. These findings demonstrate the potential of ICAM-1-targeting aptamers as antiviral agents capable of preventing HRV entry. By targeting a host receptor and creating a protective barrier at the cell surface, this approach may offer a broadly applicable strategy against multiple HRV serotypes, paving the way for the development of novel antiviral interventions. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=131 SRC="FIGDIR/small/717810v1_ufig1.gif" ALT="Figure 1"> View larger version (26K): org.highwire.dtl.DTLVardef@50e61dorg.highwire.dtl.DTLVardef@1338142org.highwire.dtl.DTLVardef@6b45e8org.highwire.dtl.DTLVardef@bac228_HPS_FORMAT_FIGEXP M_FIG C_FIG

Despite of the highly potent antiretroviral therapies, HIV-1 establishes persistent infection and causes chronic inflammation in AIDS patients. Beyond CD4+ T cells, HIV-1 infects myeloid cells, including circulating monocytes and tissue-resident macrophages, and integrates with host genomes to form stable viral reservoirs. To achieve a functional HIV cure, latency-promoting agents (LPAs) have been developed for the "block-and-lock" strategy to reinforce deep HIV-1 latency and permanently silence proviruses. However, most LPAs have been tested mainly in CD4+ T cells, and their efficacy in myeloid cells remains unclear. In this study, we reported that levosimendan (LSM), a drug approved for clinic use to treat heart failures, is able to inhibit HIV lytic infection and reactivation in myeloid cells. LSM blocked viral lytic reactivation in HIV-1 latently infected monocytic cells (TH89GFP, U1) and microglial cells (HC69). LSM also inhibited HIV infection in human induced pluripotent stem cell (iPSC) derived microglia (iMG), primary human resident liver macrophages (Kupffer cells) as well as human monocyte-derived macrophages (MDMs). Furthermore, we demonstrated that overexpression of a predicted drug target of LSM, the conserved serine/threonine kinase RIOK1 (RIO kinase 1), overcomes LSMs anti-HIV effect. Overall, our studies concluded that LSM is a promising LPA to inhibit HIV-1 infection in myeloid cells in the RIOK1-dependent manner.

BackgroundThere is currently no approved antiviral therapy against measles virus (MeV). Repurposing available compounds with broad antiviral activity may rapidly identify candidate drugs for clinical evaluation. Here we evaluated the antiviral activity of the clinically approved drugs azelastine hydrochloride and zafirlukast as well as the flavonoids quercetin and isoquercetin against MeV in preventative and therapeutic in vitro studies. MethodsCompounds were tested for antiviral activity against MeV in preventative (prophylactic and virucidal) and therapeutic (steady-state and persistent) assays in Vero/hSLAM cells. Viral loads and cell viability were measured 48h post-infection, and dose-response curves were used to calculate EC50 values. Flavonoids were also tested in the presence of 1 mM ascorbic acid. ResultsAzelastine hydrochloride did not show evidence of antiviral activity against MeV under these conditions, whereas zafirlukast, quercetin, and isoquercetin showed therapeutic activity against MeV. The addition of ascorbic acid enhanced the therapeutic potency of quercetin to 4.2-4.8 {micro}M and of isoquercetin to 10.7-10.9 {micro}M. Antiviral activity was dose-dependent when administered post-infection. ConclusionAmong the four compounds tested, quercetin showed the most potent therapeutic antiviral activity against MeV in vitro. Isoquercetin and zafirkulast also showed therapeutic activity. These findings support further evaluation of quercetin, isoquercetin, and zafirlukast as candidate antiviral drugs for MeV and highlight the utility of in vitro platforms for rapid antiviral drug screening.

Sudan virus (SUDV) is a member of the family Filoviridae, which comprises highly pathogenic viruses associated with unusually high case fatality rates. The development of medical countermeasures against filoviruses, including antivirals, vaccines, and therapeutic antibodies, requires preclinical evaluation in suitable animal models. C57BL/6J IFNAR-/- mice, which lack the type I interferon (IFN-/{beta}) receptor, have been reported to be susceptible to filovirus infections, although their impaired innate immune response may represent a potential limitation of the model. Here, we show that IFNAR-/- mice constitute a suitable model for SUDV infection. Following infection, animals developed a clear clinical disease characterized by significant weight loss and pronounced changes in behaviour and appearance. Mice reached the predefined clinical endpoint 3-5 days post infection. Post mortem analysis of terminal samples revealed high viral loads and viral genome copies in all tested organs as well as in serum, indicating widespread systemic dissemination. Importantly, infection was associated with a marked increase in several key chemokines and cytokines linked to systemic inflammation, consistent with the development of a cytokine storm-like response. Together, these findings demonstrate that SUDV infection in IFNAR-/- mice induces systemic viral dissemination and a pronounced inflammatory response, supporting the suitability of this model for investigating filovirus pathogenesis and infection-associated immune dysregulation.

Orthohantaviruses cause severe human diseases including hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), with case fatality rates up to 40%. No FDA-approved therapeutics are currently available, highlighting urgent need for drug development following recent outbreak events. We systematically examined host protease dependencies in hantavirus replication, focusing on Signal Peptidase (SP) and Signal Peptide Peptidase (SPP) essential for viral glycoprotein maturation. Through comprehensive database mining and molecular docking analysis, we identified six potential protease inhibitors, with Compound E achieving the highest binding confidence score (-0.28) against SPP. Our analysis reveals that targeting host ER proteases represents a viable antiviral strategy, providing a systematic framework for protease-targeted antihantavirus drug development and identifying specific lead compounds for experimental validation.

Human coronavirus OC43 (HCoV-OC43) constitutes one of the most common causes of the seasonal cold but can also cause severe disease among elderly and immuno-compromised. Currently, there are no approved antiviral drugs to combat HCoV-OC43 infection. Coronaviruses are positive single-stranded RNA (+ssRNA) viruses and utilize -1 programmed ribosomal frameshifting (-1 PRF) to obtain the correct stoichiometry of viral protein components. As such, the ribosomal frameshifting stimulation element (FSE) is a promising target for antiviral drug discovery, due to its high conservation. By repurposing available drugs, we identified a group of anthracycline compounds that can reduce -1 PRF of HCoV-OC43 and reduce viral infection of cells. Furthermore, we show that anthracyclines that reduce infection also bind the FSE and reduce frameshift frequency. We also show that the selected anthracyclines reduce SARS-CoV-2 infection, but without affecting -1 PRF frequency. All together, we demonstrate that a subset of anthracyclines selectively binds and inhibit the HCoV-OC43 FSE and could thus serve as a robust framework when developing new antivirals targeting coronaviruses.

N6-methyladenosine (m6A) is a major epitranscriptomic modification that regulates RNA metabolism and affects the replication and latency reversal of human immunodeficiency virus type 1 (HIV-1) in cells. Methyltransferase-like 3 (METTL3) is the principal catalytic enzyme responsible for m6A deposition, and its pharmacological inhibition has emerged as a potential therapeutic strategy for cancer and viral infections. However, the relative potency of METTL3 inhibitors in reducing m6A levels and their effects on HIV-1 latency reversal remain undefined. Here, we compared three commercially available METTL3 inhibitors (STM2457, STM3006, and STC-15) to evaluate their ability to reduce RNA m6A levels, suppress HIV-1 latency reversal, and affect cell viability in latently infected J-Lat cells and primary CD4+ T cells. In J-Lat cells, STM3006 and STC-15 were more potent than STM2457 in reducing RNA m6A levels at 24 and 48 hours post-treatment, as reflected by lower half-maximal inhibitory concentrations (IC50). However, STM3006 and STC-15 exhibited significant cytotoxicity at concentrations above 2 {micro}M at 48 hours post-treatment, whereas STM2457 displayed minimal toxicity across all tested doses. In primary CD4+ T cells from three healthy donors, all three inhibitors reduced RNA m6A levels but induced greater cytotoxicity compared with J-Lat cells, with comparable effects at optimized concentrations. Notably, reduced RNA m6A levels correlated with diminished HIV-1 latency reversal in both J-Lat cells and a primary central memory CD4+ T cell model. Together, these findings demonstrate differential potency and cytotoxicity among METTL3 inhibitors and support a critical role for m6A RNA modification in regulating HIV-1 latency reversal.

Infection with human cytomegalovirus (HCMV) is common and usually asymptomatic in healthy individuals, but can cause severe neurological injury, particularly following congenital transmission. For symptomatic congenital infection, standard antiviral treatment is ganciclovir, with maribavir and letermovir as alternative direct-acting agents. However, their relative efficacy in clearing HCMV and restoring host transcription towards an uninfected state has not been directly assessed in a neural model. To address this, we infected human cerebral organoids with Merlin-strain HCMV and treated them for 14 days with aciclovir, ganciclovir, letermovir, or maribavir, comparing each with untreated infected organoids (NO). All four antivirals reduced HCMV RNA-seq reads relative to NO, but differed in both antiviral efficacy and their effects on host transcription. Combining new and existing data, we identified >2,500 differentially expressed host genes in infected versus uninfected organoids, with enrichment of neurodevelopmental and metabolic stress pathways. Relative to NO, antiviral treatment reduced viral load 3.3-fold with aciclovir, 20.1-fold with ganciclovir, 65.4-fold with letermovir, and 6.9-fold with maribavir. Aciclovir, ganciclovir, and maribavir produced few differentially expressed host genes relative to NO and no significant GO or KEGG enrichment. In contrast, letermovir altered 312 genes enriched for glycolysis and related metabolic processes. An mSigDB Hallmark pathway analysis showed minimal perturbation with aciclovir and letermovir, whereas ganciclovir and maribavir produced small but coordinated pathway-level shifts. This was partly in the same direction as control uninfected organoids but also with additional perturbations not seen in controls. These findings indicate that antiviral choice influences both HCMV clearance and the transcriptional state of infected neural tissue. The results support further evaluation of ganciclovir and letermovir in therapy of neural damage resulting from HCMV infection, particularly of the developing fetal brain.

Chronic co-infections by HBV and its satellite virus HDV are associated with a high risk of progression to cirrhosis and liver cancer, and therapeutic options for achieving a cure are still unsatisfactory. HBs is the main surface glycoprotein of both viruses, and is also massively secreted by infected hepatocytes in the form of empty subviral particles which suppress the host immune responses. This makes HBs an attractive target to develop therapeutic strategies. Here, we took advantage of the known interaction between the Large form HDV antigen (HDAg-L) and the small form of HBs (S-HBs) to develop a non-infectious, minimalistic reporter assay for the assembly and secretion of HDV particles. By screening the existing pharmacopeia for drugs that could interfere with S-HBs and HDAg-L co-secretion, we found that ritonavir and other Cytochrome P450 inhibitors affect the biogenesis of HBs and impair the production of infectious HDV virions. Mechanistically, we established that these drugs induce oxidative stress which dysregulates disulfide bond formation in the endoplasmic reticulum. As a consequence, the production of HBs, which depends on a dense network of disulfide bonds, is markedly affected as evidenced by an abnormal glycosylation profile, altered antigenic properties, and a poor expression of the largest form of HBs (L-HBs) which is essential to virus entry into target cells. This is associated with induction of the unfolded protein response, with the upregulation of CHOP/DDIT3 and key enzymes involved in the synthesis of the reducing metabolite glutathione (PHGDH, SHMT2, MTHFD2). Overall, our results indicate that alterations in redox homeostasis significantly impact HBs biogenesis, and reveal a druggable pathway that could be exploited to eliminate HDV in chronically infected patients. IMPACT AND IMPLICATIONSMore effective therapies are still needed to achieve a functional cure in patients chronically co-infected by HBV and HDV. In this study, we discovered that ritonavir, along with other cytochrome P450 inhibitors, can affect the production of infectious HDV particles in human hepatocyte cultures. Mechanistically, ritonavir induces oxidative stress and the unfolded protein response in the endoplasmic reticulum, thereby altering the biogenesis of HBs, the surface glycoprotein of both viruses. This work highlights the potential benefit and mechanism of action of ritonavir and related molecules in the treatment of co-infected patients.