Precision-cut liver slices as a model for evaluating therapeutic agents against hepatitis B and delta viruses

Abstract

Background: Developing new therapeutic strategies against hepatitis B virus (HBV) and hepatitis delta virus (HDV) is essential to cure these infections. Yet evaluation of host-targeting agents (HTAs) with in vitro/in vivo models remains challenging. Therefore, we assessed precision-cut liver slices (PCLS) as an HBV/HDV co-infection model to study virus-host interactions and HTAs. Methods: We generated PCLS from human liver resections and infected them ex vivo with HBV and HDV. Tissue viability and architecture were monitored by intracellular ATP, secreted albumin, and multiplexed immunofluorescence. Viral markers were assessed by quantitative PCR, western blot, and light-sheet microscopy in infected slices following treatment with a sodium taurocholate co-transporting polypeptide (NTCP)-targeting peptide, lonafarnib, or the Toll-like receptor 8 agonist selgantolimod (SLGN). Single-cell RNA sequencing was performed to characterize the cellular responses to SLGN. Results: Here we show that our ex vivo infection protocol allows the establishment of HBV and HDV infection within the liver's three-dimensional architecture. Treatment with three well-characterized HTAs produced distinct antiviral effects consistent with each mechanism: an NTCP-targeting peptide blocked entry; lonafarnib induced intracellular hepatitis delta antigen accumulation; SLGN showed anti-HBV activity not previously seen in cultured hepatocytes, indicating cross-talk between immune and infected cells within liver slices. Conclusion: These results provide the characterization of PCLS as an ex vivo model of HBV/HDV co-infection and antiviral testing. In the future, PCLS could contribute to expediting pre-clinical characterization of HTAs and to exploring alternatives to animal experimentation.