Fluoxazolevir inhibits hepatitis C virus infection in humanized chimeric mice by blocking viral membrane fusion

Nat Microbiol. 2020 Dec;5(12):1532-1541. doi: 10.1038/s41564-020-0781-2. Epub 2020 Aug 31.

Abstract

Fluoxazolevir is an aryloxazole-based entry inhibitor of hepatitis C virus (HCV). We show that fluoxazolevir inhibits fusion of HCV with hepatic cells by binding HCV envelope protein 1 to prevent fusion. Nine of ten fluoxazolevir resistance-associated substitutions are in envelope protein 1, and four are in a putative fusion peptide. Pharmacokinetic studies in mice, rats and dogs revealed that fluoxazolevir localizes to the liver. A 4-week intraperitoneal regimen of fluoxazolevir in humanized chimeric mice infected with HCV genotypes 1b, 2a or 3 resulted in a 2-log reduction in viraemia, without evidence of drug resistance. In comparison, daclatasvir, an approved HCV drug, suppressed more than 3 log of viraemia but is associated with the emergence of resistance-associated substitutions in mice. Combination therapy using fluoxazolevir and daclatasvir cleared HCV genotypes 1b and 3 in mice. Fluoxazolevir combined with glecaprevir and pibrentasvir was also effective in clearing multidrug-resistant HCV replication in mice. Fluoxazolevir may be promising as the next generation of combination drug cocktails for HCV treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antiviral Agents / administration & dosage*
  • Carbamates / administration & dosage
  • Disease Models, Animal
  • Dogs
  • Drug Therapy, Combination
  • Genotype
  • Hepacivirus / classification
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepacivirus / physiology
  • Hepatitis C / drug therapy*
  • Hepatitis C / virology
  • Humans
  • Imidazoles / administration & dosage
  • Male
  • Mice
  • Pyrrolidines / administration & dosage
  • Rats
  • Rats, Sprague-Dawley
  • Valine / administration & dosage
  • Valine / analogs & derivatives
  • Viral Envelope Proteins / genetics
  • Viral Envelope Proteins / metabolism
  • Virus Internalization / drug effects*

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Pyrrolidines
  • Viral Envelope Proteins
  • Valine
  • daclatasvir