HBVZ10, an AAV8 vector-based new HBV therapy candidate for cccDNA elimination.

Abstract

Eliminating hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) remains a major challenge, requiring innovative treatment strategies and drug candidates. Clinical studies reveal that wild-type HBV in the blood is often replaced by gradually rising mutant populations. This replacement reflects loss of the early cccDNA pool, then replenished predominantly through de novo infection. We proposed that blocking de novo infection is essential for cccDNA elimination and establishing a finite HBV treatment regimen. To achieve sustained inhibition of de novo cccDNA replenishment, we developed HBVZ10, a gene therapy candidate that utilizes an optimized adeno-associated virus (AAV) vector 8 to deliver human anti-HBs antibody genes into muscle cells for expanding endogenous anti-HBs antibody production capacity. HBVZ10 expression and therapeutic function were evaluated in uPA/SCID chimeric mice. HBVZ10 therapy achieved sustained antibody expression of ≥100,000 mIU/mL for at least 200 days following a single dose administration. Combining HBVZ10 with intracellular replication inhibitor entecavir resulted in >100-fold reductions in cccDNA within a few months, accompanied by progressive reductions in serum HBeAg and HBsAg to undetectable levels. These findings establish preclinical evidence of HBVZ10 as a novel gene therapy candidate and support a paradigm-shifting cccDNA elimination strategy.