1 5955 128 TELBIVUDINE TREATMENT CORRECTS HBV-INDUCED EPIGENETIC ALTERATIONS IN LIVER CELLS OF PATIENTS WITH CHRONIC HEPATITIS B. HEPATITIS B VIRUS (HBV) ALTERS THE EXPRESSION OF HOST CELLULAR GENES TO SUPPORT ITS REPLICATION AND SURVIVAL AND TO PROMOTE THE LIVER CELL INJURY. HOWEVER, THE UNDERLYING MECHANISM REMAINED INCOMPLETELY UNDERSTOOD. IN THIS STUDY, WE INVESTIGATED HBV-INDUCED EPIGENETIC CHANGES IN HEPG2 CELLS BY PROFILING THE LANDSCAPES OF THE ACTIVE HISTONE MODIFICATION MARK H3K4ME3 AND REPRESSIVE MARK H3K27ME3 USING CHROMATIN IMMUNOPRECIPITATION-SEQUENCING. HBV CAUSED THE ALTERED HISTONE MODIFICATIONS AT THOUSANDS OF GENOMIC LOCI, WHICH ARE CRITICALLY INVOLVED IN HBV ENTRY, INFLAMMATION, FIBROSIS AND CARCINOGENESIS OF HOST CELLS. INTERESTINGLY, TREATMENT OF THE HBV-TRANSFORMED HEPG2 CELLS WITH THE ANTI-HBV DRUG TELBIVUDINE SUBSTANTIALLY RESTORED THE H3K4ME3 LEVEL TO THAT OF UNTRANSFORMED HEPG2 CELLS. MORE IMPORTANTLY, OUR ANALYSIS OF LIVER SAMPLES FROM CONTROL AND CHRONIC HEPATITIS B PATIENTS REVEALED THAT TREATMENT OF THE PATIENTS WITH TELBIVUDINE NOT ONLY CORRECTED THE TARGET GENE EXPRESSION BUT ALSO THE EPIGENETIC MODIFICATION OF CRITICAL GENES. IN ADDITION, THE EXPRESSION OF THE HISTONE METHYLTRANSFERASES SMYD3 AND EZH2 THAT REGULATE HISTONE H3-SPECIFIC METHYLATION SHOWED NO DIFFERENCE IN HEPG2 CELL WITH OR WITHOUT HBV EXISTENCE. THUS, OUR DATA SUGGEST THAT ABNORMAL HISTONE MODIFICATIONS MIGHT CRITICALLY INVOLVED IN HBV-MEDIATED LIVER PATHOGENESIS AND TELBIVUDINE THERAPY MIGHT BENEFIT PATIENTS WITH HBV-RELATED CHRONIC INFECTION, LIVER CIRRHOSIS AND EVEN HEPATIC CARCINOMA. SUMMARY: TELBIVUDINE SUBSTANTIALLY RESTORES IN VITRO AND IN VIVO HBV-CAUSED ABNORMAL EXPRESSIONS AND HISTONE H3K4ME3 AND H3K27ME3 MODIFICATIONS AT THOUSANDS OF GENOMIC LOCI THAT ARE INVOLVED IN THE PATHOGENESIS OF LIVER CELLS, REVEALING A NOVEL MECHANISM FOR HBV-MEDIATED LIVER DAMAGE. 2014 2 6337 25 THE ROLE OF DNA-METHYLTRANSFERASES IN THE LIFE CYCLE OF HEPATITIS B VIRUS AND PATHOGENESIS OF CHRONIC HEPATITIS B. CHRONIC HEPATITIS B IS CAUSED BY A PERSISTENT FORM OF HEPATITIS B VIRUS, COVALENTLY CLOSED CIRCULAR DNA (CCCDNA). STABILITY OF CCCDNA IS ASSOCIATED WITH INTRACELLULAR LOCALIZATION OF CCCDNA AND FORMATION OF MINICHROMOSOME, REGULATED BY EPIGENETIC MECHANISMS. ONE OF THE KEY MECHANISMS IN EPIGENETICS IS METHYLATION OF DNA ON CPG ISLANDS. EXPRESSION LEVELS OF DNA-METHYLTRANSFERASES (DNMTS) IN CHRONIC HEPATITIS B PATIENTS WERE SHOWN TO BE UPREGULATED. NEVERTHELESS, THE ROLE OF DNMTS IN THE LIFE CYCLE OF HBV AND THEIR EFFECTS ON THE CELL REMAIN ELUSIVE. IN THIS REVIEW, WE DISCUSS LATEST ACHIEVEMENTS ON THE ROLE OF DNMTS IN CHRONIC HEPATITIS B AND HBV IN VITRO MODELS. 2018 3 4056 47 MAPPING THE HETEROGENEITY OF HISTONE MODIFICATIONS ON HEPATITIS B VIRUS DNA USING LIVER NEEDLE BIOPSIES OBTAINED FROM CHRONICALLY INFECTED PATIENTS. COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) FORMS THE BASIS FOR REPLICATION AND PERSISTENCE OF HEPATITIS B VIRUS (HBV) IN THE CHRONICALLY INFECTED LIVER. WE HAVE PREVIOUSLY SHOWN THAT VIRAL TRANSCRIPTION IS SUBJECT TO REGULATION BY POSTTRANSLATIONAL MODIFICATIONS (PTMS) OF HISTONE PROTEINS BOUND TO CCCDNA THROUGH ANALYSIS OF DE NOVO HBV-INFECTED CELL LINES. WE NOW REPORT THE SUCCESSFUL ADAPTATION OF THIS CHROMATIN IMMUNOPRECIPITATION SEQUENCING (CHIPSEQ) APPROACH FOR ANALYSIS OF FINE-NEEDLE PATIENT LIVER BIOPSY SPECIMENS TO INVESTIGATE THE ROLE OF HISTONE PTMS IN CHRONICALLY HBV-INFECTED PATIENTS. USING 18 SPECIMENS FROM PATIENTS IN DIFFERENT STAGES OF CHRONIC HBV INFECTION, OUR WORK SHOWS THAT THE PROFILE OF HISTONE PTMS IN CHRONIC INFECTION IS MORE NUANCED THAN PREVIOUSLY OBSERVED IN IN VITRO MODELS OF ACUTE INFECTION. IN LINE WITH OUR PREVIOUS FINDINGS, WE FIND THAT THE MAJORITY OF HBV-DERIVED SEQUENCES ARE ASSOCIATED WITH THE ACTIVATING HISTONE PTM H3K4ME3. HOWEVER, WE SHOW A STRIKING INTERPATIENT VARIABILITY OF ITS DEPOSITION IN THIS PATIENT COHORT CORRELATED WITH VIRAL TRANSCRIPTION AND PATIENT HBV EARLY ANTIGEN (HBEAG) STATUS. UNEXPECTEDLY, WE DETECTED DEPOSITION OF THE CLASSICAL INHIBITORY HISTONE PTM H3K9ME3 ON HBV-DNA IN AROUND HALF OF THE PATIENT BIOPSY SPECIMENS, WHICH COULD NOT BE LINKED TO REDUCED LEVELS OF VIRAL TRANSCRIPTS. OUR RESULTS SHOW THAT CURRENT IN VITRO MODELS ARE UNABLE TO FULLY RECAPITULATE THE COMPLEX EPIGENETIC LANDSCAPE OF CHRONIC HBV INFECTION OBSERVED IN VIVO AND DEMONSTRATE THAT FINE-NEEDLE LIVER BIOPSY SPECIMENS CAN PROVIDE SUFFICIENT MATERIAL TO FURTHER INVESTIGATE THE INTERACTION OF VIRAL AND HOST PROTEINS ON HBV-DNA.IMPORTANCE HEPATITIS B VIRUS (HBV) IS A MAJOR GLOBAL HEALTH CONCERN, CHRONICALLY INFECTING MILLIONS OF PATIENTS AND CONTRIBUTING TO A RISING BURDEN OF LIVER DISEASE. THE VIRAL GENOME FORMS THE BASIS FOR CHRONIC INFECTION AND HAS BEEN SHOWN TO BE SUBJECT TO REGULATION BY EPIGENETIC MECHANISMS, SUCH AS POSTTRANSLATIONAL MODIFICATION OF HISTONE PROTEINS. HERE, WE CONFIRM AND EXPAND ON PREVIOUS RESULTS BY ADAPTING A HIGH-RESOLUTION TECHNIQUE FOR ANALYSIS OF HISTONE MODIFICATIONS FOR USE WITH PATIENT-DERIVED FINE-NEEDLE LIVER BIOPSY SPECIMENS. OUR WORK HIGHLIGHTS THAT THE SITUATION IN VIVO IS MORE COMPLEX THAN PREDICTED BY CURRENT IN VITRO MODELS, FOR EXAMPLE, BY SUGGESTING A NOVEL, NONCANONICAL ROLE OF THE HISTONE MODIFICATION H3K9ME3 IN THE HBV LIFE CYCLE. IMPORTANTLY, ENABLING THE USE OF FINE-NEEDLE LIVER BIOPSY SPECIMENS FOR SUCH HIGH-RESOLUTION ANALYSES MAY FACILITATE FURTHER RESEARCH INTO THE EPIGENETIC REGULATION OF THE HBV GENOME. 2019 4 5547 36 ROLE OF EPIGENETIC MODIFICATION IN INTERFERON TREATMENT OF HEPATITIS B VIRUS INFECTION. HUMAN HEPATITIS B VIRUS (HBV) IS A SMALL, ENVELOPED DNA VIRUS THAT CAUSES ACUTE AND CHRONIC HEPATITIS. CHRONIC HEPATITIS B (CHB) IS ASSOCIATED WITH HEPATOCELLULAR CARCINOMA PATHOGENESIS. INTERFERONS (IFNS) HAVE BEEN USED FOR THE TREATMENT OF CHB FOR A LONG TIME, WITH ADVANTAGES INCLUDING LESS TREATMENT DURATION AND SUSTAINED VIROLOGICAL RESPONSE. PRESENTLY, VARIOUS EVIDENCE SUGGESTS THAT EPIGENETIC MODIFICATION OF THE VIRAL COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) AND THE HOST GENOME IS CRUCIAL FOR THE REGULATION OF VIRAL ACTIVITY. THIS MODIFICATION INCLUDES HISTONE ACETYLATION, DNA METHYLATION, N6-METHYLADENOSINE, AND NON-CODING RNA MODIFICATION. IFN TREATMENT FOR CHB CAN STIMULATE MULTIPLE IFN-STIMULATED GENES FOR INHIBITING VIRUS REPLICATION. IFNS CAN ALSO AFFECT THE HBV LIFE CYCLE THROUGH EPIGENETIC MODULATION. IN THIS REVIEW, WE SUMMARIZED THE DIFFERENT MECHANISMS THROUGH WHICH IFN-ALPHA INHIBITS HBV REPLICATION, INCLUDING EPIGENETIC REGULATION. MOREOVER, THE MECHANISMS UNDERLYING IFN ACTIVITY ARE DISCUSSED, WHICH INDICATED ITS POTENTIAL AS A NOVEL TREATMENT FOR CHB. IT IS PROPOSED THAT EPIGENETIC CHANGES SUCH AS HISTONE ACETYLATION, DNA METHYLATION, M6A METHYLATION COULD BE THE TARGETS OF IFN, WHICH MAY OFFER A NOVEL APPROACH TO HBV TREATMENT. 2022 5 1615 35 DNA METHYLTRANSFERASE 3B PLAYS A PROTECTIVE ROLE AGAINST HEPATOCARCINOGENESIS CAUSED BY CHRONIC INFLAMMATION VIA MAINTAINING MITOCHONDRIAL HOMEOSTASIS. MOST HEPATOCELLULAR CARCINOMAS (HCCS) DEVELOP ON THE BASIS OF CHRONIC HEPATITIS, BUT THE MECHANISM OF EPIGENETIC REGULATION IN INFLAMMATORY HEPATOCARCINOGENESIS HAS YET TO BE ELUCIDATED. AMONG DE NOVO DNA METHYLTRANSFERASES (DNMTS), DNMT3B HAS LATELY BEEN REPORTED TO ACT SPECIFICALLY ON ACTIVELY TRANSCRIBED GENES, SUGGESTING THE POSSIBILITY THAT IT PLAYS A ROLE IN THE PATHOGENESIS OF CANCER. WE CONFIRMED THAT DNMT3B ISOFORMS LACKING ITS CATALYTIC DOMAIN WERE HIGHLY EXPRESSED IN HCCS COMPARED WITH NON-TUMOROUS LIVER TISSUE. TO ELUCIDATE THE ROLE OF DNMT3B IN HEPATOCARCINOGENESIS, WE GENERATED A GENETICALLY ENGINEERED MOUSE MODEL WITH HEPATOCYTE-SPECIFIC DNMT3B DELETION. THE LIVER OF THE DNMT3B-DEFICIENT MICE EXHIBITED AN EXACERBATION OF THIOACETAMIDE-INDUCED HEPATITIS, PROGRESSION OF LIVER FIBROSIS AND A HIGHER INCIDENCE OF HCC COMPARED WITH THE LIVER OF THE CONTROL MICE. WHOLE-GENOME BISULFITE SEQUENCING VERIFIED A LOWER CG METHYLATION LEVEL IN THE DNMT3B-DEFICIENT LIVER, DEMONSTRATING DIFFERENTIALLY METHYLATED REGIONS THROUGHOUT THE GENOME. TRANSCRIPTOME ANALYSIS REVEALED DECREASED EXPRESSION OF GENES RELATED TO OXIDATIVE PHOSPHORYLATION IN THE DNMT3B-DEFICIENT LIVER. MOREOVER, PRIMARY HEPATOCYTES ISOLATED FROM THE DNMT3B-DEFICIENT MICE SHOWED REDUCED MITOCHONDRIAL RESPIRATORY CAPACITY, LEADING TO THE ENHANCEMENT OF OXIDATIVE STRESS IN THE LIVER TISSUE. OUR FINDINGS SUGGEST THE PROTECTIVE ROLE OF DNMT3B AGAINST CHRONIC INFLAMMATION AND HCC DEVELOPMENT VIA MAINTAINING MITOCHONDRIAL HOMEOSTASIS. 2020 6 3189 34 HBX RELIEVES CHROMATIN-MEDIATED TRANSCRIPTIONAL REPRESSION OF HEPATITIS B VIRAL CCCDNA INVOLVING SETDB1 HISTONE METHYLTRANSFERASE. BACKGROUND & AIMS: MAINTENANCE OF THE COVALENTLY CLOSED CIRCULAR HBV DNA (CCCDNA) THAT SERVES AS A TEMPLATE FOR HBV TRANSCRIPTION IS RESPONSIBLE FOR THE FAILURE OF ANTIVIRAL THERAPIES. WHILE STUDIES IN CHRONIC HEPATITIS PATIENTS HAVE SHOWN THAT HIGH VIREMIA CORRELATES WITH HYPERACETYLATION OF CCCDNA-ASSOCIATED HISTONES, THE MOLECULAR MECHANISMS CONTROLLING CCCDNA STABILITY AND TRANSCRIPTIONAL REGULATION ARE STILL POORLY UNDERSTOOD. THIS STUDY AIMED TO DECIPHER THE ROLE OF CHROMATIN AND CHROMATIN MODIFIER PROTEINS ON HBV TRANSCRIPTION. METHODS: WE ANALYZED THE CHROMATIN STRUCTURE OF ACTIVELY TRANSCRIBED OR SILENCED CCCDNA BY INFECTING PRIMARY HUMAN HEPATOCYTES AND DIFFERENTIATED HEPARG CELLS WITH WILD-TYPE VIRUS OR VIRUS DEFICIENT (HBVX-) FOR THE EXPRESSION OF HEPATITIS B VIRUS X PROTEIN (HBX), THAT IS REQUIRED FOR HBV EXPRESSION. RESULTS: IN THE ABSENCE OF HBX, HBV CCCDNA WAS TRANSCRIPTIONALLY SILENCED WITH THE CONCOMITANT DECREASE OF HISTONE 3 (H3) ACETYLATION AND H3K4ME3, INCREASE OF H3 DI- AND TRI-METHYLATION (H3K9ME) AND THE RECRUITMENT OF HETEROCHROMATIN PROTEIN 1 FACTORS (HP1) THAT CORRELATE WITH CONDENSED CHROMATIN. SETDB1 WAS FOUND TO BE THE MAIN HISTONE METHYLTRANSFERASE RESPONSIBLE FOR THE DEPOSITION OF H3K9ME3 AND HBV REPRESSION. FINALLY, FULL TRANSCRIPTIONAL REACTIVATION OF HBVX- UPON HBX RE-EXPRESSION CORRELATED WITH AN INCREASE OF HISTONE ACETYLATION AND H3K4ME3, AND A CONCOMITANT DECREASE OF HP1 BINDING AND OF H3K9ME3 ON THE CCCDNA. CONCLUSION: UPON HBV INFECTION, CELLULAR MECHANISMS INVOLVING SETDB1-MEDIATED H3K9ME3 AND HP1 INDUCE SILENCING OF HBV CCCDNA TRANSCRIPTION THROUGH MODULATION OF CHROMATIN STRUCTURE. HBX IS ABLE TO RELIEVE THIS REPRESSION AND ALLOW THE ESTABLISHMENT OF ACTIVE CHROMATIN. 2015 7 3255 34 HEPATITIS B VIRUS X PROTEIN MEDIATED EPIGENETIC ALTERATIONS IN THE PATHOGENESIS OF HEPATOCELLULAR CARCINOMA. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A WORLDWIDE HEALTH PROBLEM. HEPATITIS B VIRUS X PROTEIN (HBX), A PLEIOTROPIC REGULATORY PROTEIN ENCODED BY HBV, IS NECESSARY FOR THE TRANSCRIPTION OF HBV COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) MINICHROMOSOMES, AND AFFECTS THE EPIGENETIC REGULATION OF HOST CELLS. THE EPIGENETIC REPROGRAMMING OF HBX ON HOST CELL GENOME IS STRONGLY INVOLVED IN HBV-RELATED HCC CARCINOGENESIS. HERE, WE REVIEW THE LATEST FINDINGS OF THE EPIGENETIC REGULATION INDUCED BY HBX PROTEIN IN HEPATOCELLULAR CARCINOMA (HCC), INCLUDING DNA METHYLATION, HISTONE MODIFICATION AND NON-CODING RNA EXPRESSION. THE INFLUENCE OF HBX ON THE EPIGENETIC REGULATION OF CCCDNA IS ALSO SUMMARIZED. IN ADDITION, PRELIMINARY STUDIES OF TARGETED DRUGS FOR EPIGENETIC CHANGES INDUCED BY HBX ARE ALSO DISCUSSED. THE EXPLORATION OF EPIGENETIC MARKERS AS POTENTIAL TARGETS WILL HELP TO DEVELOP NEW PREVENTION AND/OR TREATMENT METHODS FOR HBX-RELATED HCC. 2022 8 4055 43 MAPPING OF HISTONE MODIFICATIONS IN EPISOMAL HBV CCCDNA UNCOVERS AN UNUSUAL CHROMATIN ORGANIZATION AMENABLE TO EPIGENETIC MANIPULATION. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION AFFECTS 240 MILLION PEOPLE WORLDWIDE AND IS A MAJOR RISK FACTOR FOR LIVER FAILURE AND HEPATOCELLULAR CARCINOMA. CURRENT ANTIVIRAL THERAPY INHIBITS CYTOPLASMIC HBV GENOMIC REPLICATION, BUT IS NOT CURATIVE BECAUSE IT DOES NOT DIRECTLY AFFECT NUCLEAR HBV CLOSED CIRCULAR DNA (CCCDNA), THE GENOMIC FORM THAT TEMPLATES VIRAL TRANSCRIPTION AND SUSTAINS VIRAL PERSISTENCE. NOVEL APPROACHES THAT DIRECTLY TARGET CCCDNA REGULATION WOULD THEREFORE BE HIGHLY DESIRABLE. CCCDNA IS ASSEMBLED WITH CELLULAR HISTONE PROTEINS INTO CHROMATIN, BUT LITTLE IS KNOWN ABOUT THE REGULATION OF HBV CHROMATIN BY HISTONE POSTTRANSLATIONAL MODIFICATIONS (PTMS). HERE, USING A NEW CCCDNA CHIP-SEQ APPROACH, WE REPORT, TO OUR KNOWLEDGE, THE FIRST GENOME-WIDE MAPS OF PTMS IN CCCDNA-CONTAINING CHROMATIN FROM DE NOVO INFECTED HEPG2 CELLS, PRIMARY HUMAN HEPATOCYTES, AND FROM HBV-INFECTED LIVER TISSUE. WE FIND HIGH LEVELS OF PTMS ASSOCIATED WITH ACTIVE TRANSCRIPTION ENRICHED AT SPECIFIC SITES WITHIN THE HBV GENOME AND, SURPRISINGLY, VERY LOW LEVELS OF PTMS LINKED TO TRANSCRIPTIONAL REPRESSION EVEN AT SILENT HBV PROMOTERS. WE SHOW THAT TRANSCRIPTION AND ACTIVE PTMS IN HBV CHROMATIN ARE REDUCED BY THE ACTIVATION OF AN INNATE IMMUNITY PATHWAY, AND THAT THIS EFFECT CAN BE RECAPITULATED WITH A SMALL MOLECULE EPIGENETIC MODIFYING AGENT, OPENING THE POSSIBILITY THAT CHROMATIN-BASED REGULATION OF CCCDNA TRANSCRIPTION COULD BE A NEW THERAPEUTIC APPROACH TO CHRONIC HBV INFECTION. 2015 9 6016 37 THE ASSOCIATION BETWEEN HEPATOCARCINOGENESIS AND INTRACELLULAR ALTERATIONS DUE TO HEPATITIS B VIRUS INFECTION. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A WORLDWIDE HEALTH PROBLEM LEADING TO SEVERE LIVER DYSFUNCTION, INCLUDING LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA. ALTHOUGH CURRENT ANTIVIRAL THERAPIES FOR CHRONIC HBV INFECTION HAVE BEEN IMPROVED AND CAN LEAD TO A STRONG SUPPRESSION OF VIRAL REPLICATION, IT IS DIFFICULT TO COMPLETELY ELIMINATE THE VIRUS WITH THESE THERAPIES ONCE CHRONIC HBV INFECTION IS ESTABLISHED IN THE HOST. FURTHERMORE, CHRONIC HBV INFECTION ALTERS INTRACELLULAR METABOLISM AND SIGNALLING PATHWAYS, RESULTING IN THE ACTIVATION OF CARCINOGENESIS IN THE LIVER. HBV PRODUCES FOUR VIRAL PROTEINS: HEPATITIS B SURFACE-, HEPATITIS B CORE-, HEPATITIS B X PROTEIN, AND POLYMERASE; EACH PLAYS AN IMPORTANT ROLE IN HBV REPLICATION AND THE INTRACELLULAR SIGNALLING PATHWAYS ASSOCIATED WITH HEPATOCARCINOGENESIS. IN VITRO AND IN VIVO EXPERIMENTAL MODELS FOR ANALYZING HBV INFECTION AND REPLICATION HAVE BEEN ESTABLISHED, AND GENE EXPRESSION ANALYSES USING MICROARRAYS OR NEXT-GENERATION SEQUENCING HAVE ALSO BEEN DEVELOPED. THUS, IT IS POSSIBLE TO CLARIFY THE MOLECULAR MECHANISMS FOR INTRACELLULAR ALTERATIONS, SUCH AS ENDOPLASMIC RETICULUM STRESS, OXIDATIVE STRESS, AND EPIGENETIC MODIFICATIONS. IN THIS REVIEW, THE IMPACT OF HBV VIRAL PROTEINS AND INTRACELLULAR ALTERATIONS IN HBV-ASSOCIATED HEPATOCARCINOGENESIS ARE DISCUSSED. 2021 10 2939 33 GENETIC AND EPIGENETIC ALTERATIONS IN HEPATITIS B VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA. HEPATITIS B VIRUS (HBV) IS A MAJOR CAUSE OF HEPATOCELLULAR CARCINOMA (HCC). ITS CHRONIC INFECTION CAN LEAD TO CHRONIC LIVER INFLAMMATION AND THE ACCUMULATION OF GENETIC ALTERATIONS TO RESULT IN THE ONCOGENIC TRANSFORMATION OF HEPATOCYTES. HBV CAN ALSO SENSITIZE HEPATOCYTES TO ONCOGENIC TRANSFORMATION BY CAUSING GENETIC AND EPIGENETIC CHANGES OF THE HOST CHROMOSOMES. HBV DNA CAN INSERT INTO HOST CHROMOSOMES AND RECENT LARGE-SCALE WHOLE-GENOME SEQUENCING STUDIES REVEALED RECURRENT HBV DNA INTEGRATIONS SITES THAT MAY PLAY IMPORTANT ROLES IN THE INITIATION OF HEPATOCELLULAR CARCINOGENESIS. HBV CAN ALSO CAUSE EPIGENETIC CHANGES BY ALTERING THE METHYLATION STATUS OF CELLULAR DNA, THE POST-TRANSLATIONAL MODIFICATION OF HISTONES, AND THE EXPRESSION OF MICRORNAS. THESE CHANGES CAN ALSO LEAD TO THE EVENTUAL HEPATOCELLULAR TRANSFORMATION. THESE RECENT FINDINGS ON THE GENETIC AND EPIGENETIC ALTERATIONS OF THE HOST CHROMOSOMES INDUCED BY HBV OPENED A NEW AVENUE FOR THE DEVELOPMENT OF NOVEL DIAGNOSIS AND TREATMENTS FOR HBV-INDUCED HCC. 2015 11 4920 35 PARALLEL EPIGENETIC AND GENETIC CHANGES IN THE PATHOGENESIS OF HEPATITIS VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA. HEPATOCELLULAR CARCINOMA (HCC) IS ONE OF THE MOST FREQUENT TUMOR TYPES IN THE WORLD, WITH SHORT SURVIVAL TIMES AND FEW TREATMENT OPTIONS. HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV) ARE MAJOR ETIOLOGIC AGENTS OF HCC, ALTHOUGH THE ASSOCIATED MECHANISMS ARE INCOMPLETELY UNDERSTOOD. THE AVAILABLE EVIDENCE SUGGESTS THAT BOTH VIRUSES PROMOTE TUMORIGENESIS BY UP-REGULATING GENES THAT PROMOTE HEPATOCELLULAR GROWTH AND SURVIVAL, AND BY DOWN-REGULATING OTHER GENES THAT ACT AS TUMOR SUPPRESSORS AND NEGATIVE GROWTH REGULATORY MOLECULES. SIGNIFICANTLY, A NUMBER OF THE PATHWAYS THAT ARE ALTERED BY THESE VIRUSES ARE THE SAME ONES THAT ACCUMULATE GENETIC ALTERATIONS DURING TUMOR PROGRESSION. THIS SUGGESTS THAT THE PATHWAYS THAT PROMOTE VIRUS PERSISTENCE AND REPLICATION MAY ALSO PROMOTE CELL GROWTH AND SURVIVAL. FROM THE PERSPECTIVE OF THE VIRUS, THIS PROMOTES CHRONIC INFECTION, WHILE FROM THE PERSPECTIVE OF THE HOST, THIS PROMOTES TUMORIGENESIS. 2006 12 4127 44 MECHANISMS OF DNA METHYLATION IN VIRUS-HOST INTERACTION IN HEPATITIS B INFECTION: PATHOGENESIS AND ONCOGENETIC PROPERTIES. HEPATITIS B VIRUS (HBV), THE WELL-STUDIED ONCOVIRUS THAT CONTRIBUTES TO THE MAJORITY OF HEPATOCELLULAR CARCINOMAS (HCC) WORLDWIDE, CAN CAUSE A SEVERE INFLAMMATORY MICROENVIRONMENT LEADING TO GENETIC AND EPIGENETIC CHANGES IN HEPATOCYTE CLONES. HBV REPLICATION CONTRIBUTES TO THE REGULATION OF DNA METHYLTRANSFERASE GENE EXPRESSION, PARTICULARLY BY X PROTEIN (HBX), AND SUBSEQUENT METHYLATION CHANGES MAY LEAD TO ABNORMAL TRANSCRIPTION ACTIVATION OF ADJACENT GENES AND GENOMIC INSTABILITY. UNDOUBTEDLY, THE ALTERED EXPRESSION OF THESE GENES HAS BEEN KNOWN TO CAUSE DIVERSE ASPECTS OF INFECTED HEPATOCYTES, INCLUDING APOPTOSIS, PROLIFERATION, REACTIVE OXYGEN SPECIES (ROS) ACCUMULATION, AND IMMUNE RESPONSES. ADDITIONALLY, POLLUTANT-INDUCED DNA METHYLATION CHANGES AND ABERRANT METHYLATION OF IMPRINTED GENES IN HEPATOCYTES ALSO COMPLICATE THE PROCESS OF TUMORIGENESIS. MEANWHILE, HEPATOCYTES ALSO CONTRIBUTE TO EPIGENETIC MODIFICATION OF THE VIRAL GENOME TO AFFECT HBV REPLICATION OR VIRAL PROTEIN PRODUCTION. MEANWHILE, METHYLATION LEVELS OF HBV INTEGRANTS AND SURROUNDING HOST REGIONS ALSO PLAY CRUCIAL ROLES IN THEIR ABILITY TO PRODUCE VIRAL PROTEINS IN AFFECTED HEPATOCYTES. BOTH HOST AND VIRAL CHANGES CAN PROVIDE NOVEL INSIGHTS INTO TUMORIGENESIS, INDIVIDUALIZED RESPONSES TO THERAPEUTIC INTERVENTION, DISEASE PROGRESS, AND EARLY DIAGNOSIS. AS SUCH, DNA METHYLATION-MEDIATED EPIGENETIC SILENCING OF CANCER-RELATED GENES AND VIRAL REPLICATION IS A COMPELLING THERAPEUTIC GOAL TO REDUCE MORBIDITY AND MORTALITY FROM LIVER CANCER CAUSED BY CHRONIC HBV INFECTION. IN THIS REVIEW, WE SUMMARIZE THE MOST RECENT RESEARCH ON ABERRANT DNA METHYLATION ASSOCIATED WITH HBV INFECTION, WHICH IS INVOLVED IN HCC DEVELOPMENT, AND PROVIDE AN OUTLOOK ON THE FUTURE DIRECTION OF THE RESEARCH. 2021 13 2165 45 EPIGENETIC MECHANISMS IN HEPATITIS B VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA. CHRONIC INFECTION OF THE LIVER BY THE HEPATITIS B VIRUS (HBV) IS ASSOCIATED WITH INCREASED RISK FOR DEVELOPING HEPATOCELLULAR CARCINOMA (HCC). A MULTITUDE OF STUDIES HAVE INVESTIGATED THE MECHANISM OF LIVER CANCER PATHOGENESIS DUE TO CHRONIC HBV INFECTION. CHRONIC INFLAMMATION, EXPRESSION OF SPECIFIC VIRAL PROTEINS SUCH AS HBX, THE INTEGRATION SITE OF THE VIRAL GENOME INTO THE HOST GENOME, AND THE VIRAL GENOTYPE, ARE KEY PLAYERS CONTRIBUTING TO HCC PATHOGENESIS. IN ADDITION, THE GENETIC BACKGROUND OF THE HOST AND EXPOSURE TO ENVIRONMENTAL CARCINOGENS ARE ALSO PREDISPOSING PARAMETERS IN HEPATOCARCINOGENESIS. DESPITE THE PLETHORA OF STUDIES, THE MOLECULAR MECHANISM OF HCC PATHOGENESIS REMAINS INCOMPLETELY UNDERSTOOD. IN THIS REVIEW, THE FOCUS IS ON EPIGENETIC MECHANISMS INVOLVED IN THE PATHOGENESIS OF HBV-ASSOCIATED HCC. EPIGENETIC MECHANISMS ARE DYNAMIC MOLECULAR PROCESSES THAT REGULATE GENE EXPRESSION WITHOUT ALTERING THE HOST DNA, ACTING BY MODIFYING THE HOST CHROMATIN STRUCTURE VIA COVALENT POST-TRANSLATIONAL HISTONE MODIFICATIONS, CHANGING THE DNA METHYLATION STATUS, EXPRESSION OF NON-CODING RNAS SUCH AS MICRORNAS AND LONG NONCODING RNAS, AND ALTERING THE SPATIAL, 3-D ORGANIZATION OF THE CHROMATIN OF THE VIRUS-INFECTED CELL. HEREIN, STUDIES ARE DESCRIBED THAT PROVIDE EVIDENCE IN SUPPORT OF DEREGULATION OF EPIGENETIC MECHANISMS IN THE HBV-INFECTED/-REPLICATING HEPATOCYTE AND THEIR CONTRIBUTION TO HEPATOCYTE TRANSFORMATION. IN CONTRAST TO GENETIC MUTATIONS WHICH ARE PERMANENT, EPIGENETIC ALTERATIONS ARE DYNAMIC AND REVERSIBLE. ACCORDINGLY, THE IDENTIFICATION OF ESSENTIAL MOLECULAR EPIGENETIC TARGETS INVOLVED IN HBV-MEDIATED HCC PATHOGENESIS OFFERS THE OPPORTUNITY FOR THE DESIGN AND DEVELOPMENT OF NOVEL EPIGENETIC THERAPEUTIC APPROACHES. 2021 14 6707 32 VIRAL HEPATITIS AND HEPATOCELLULAR CARCINOMA: STATE OF THE ART. VIRAL HEPATITIS IS ONE OF THE MAIN CAUSES LEADING TO HEPATOCELLULAR CARCINOMA (HCC). THE CONTINUED RISE IN INCIDENCE OF HCC SUGGESTS ADDITIONAL FACTORS FOLLOWING INFECTION MAY BE INVOLVED. THIS REVIEW EXAMINES RECENT STUDIES INVESTIGATING THE MOLECULAR MECHANISMS OF CHRONIC HEPATITIS AND ITS ASSOCIATION WITH HEPATOCARCINOGENESIS. HEPATITIS B VIRUS PATIENTS WITH GENOTYPE C DISPLAY AN AGGRESSIVE DISEASE COURSE LEADING TO HCC MORE THAN OTHER GENOTYPES. FURTHERMORE, HEPATITIS B EXCRETORY ANTIGEN (HBEAG) SEEMS TO BE A MORE SENSITIVE PREDICTIVE TUMOR MARKER EXHIBITING A SIX-FOLD HIGHER RELATIVE RISK IN PATIENTS WITH POSITIVE HBSAG AND HBEAG THAN THOSE WITH HBSAG ONLY. SINGLE OR COMBINED MUTATIONS OF VIRAL GENOME CAN PREDICT HCC DEVELOPMENT IN UP TO 80% OF PATIENTS. SEVERAL MUTATIONS IN HBX-GENE ARE RELATED WITH HIGHER HCC INCIDENCE. OVEREXPRESSION OF THE CORE PROTEIN IN HCV LEADS TO HEPATOCELLULAR LIPID ACCUMULATION ASSOCIATED WITH ONCOGENESIS. REDUCED NUMBER AND DECREASED FUNCTIONALITY OF NATURAL KILLER CELLS IN CHRONIC HCV INDIVIDUALS DYSREGULATE THEIR SURVEILLANCE FUNCTION IN TUMOR AND VIRAL CELLS RESULTING IN HCC. FURTHERMORE, HIGH T-CELL IMMUNOGLOBULIN AND MUCIN 3 LEVELS SUPRESS CD8+ T-CELLS, WHICH LEAD TO IMMUNOLOGICAL DYSREGULATION. HEPATITIS D PROMOTES HCC DEVELOPMENT INDIRECTLY VIA MODIFICATIONS TO INNATE IMMUNITY, EPIGENETIC ALTERATIONS AND PRODUCTION OF REACTIVE OXYGEN SPECIES WITH THE LHDAG BEING THE MOST HIGHLY ASSOCIATED WITH HCC DEVELOPMENT. SUMMARIZING THE RESULTS, HBV AND HCV INFECTION REPRESENT THE MOST ASSOCIATED FORMS OF VIRAL HEPATITIS CAUSING HCC. FURTHER STUDIES ARE WARRANTED TO FURTHER IMPROVE THE PREDICTION OF HIGH-RISK PATIENTS AND DEVELOPMENT OF TARGETED THERAPEUTICS PREVENTING THE TRANSITION FROM HEPATIC INFLAMMATION-FIBROSIS TO CANCER. 2021 15 6115 39 THE EPIGENETIC CONTROL OF HEPATITIS B VIRUS MODULATES THE OUTCOME OF INFECTION. EPIGENETIC MODIFICATIONS ARE STABLE ALTERATIONS IN GENE EXPRESSION THAT DO NOT INVOLVE MUTATIONS OF THE GENETIC SEQUENCE ITSELF. IT HAS BECOME INCREASINGLY CLEAR THAT EPIGENETIC FACTORS CONTRIBUTE TO THE OUTCOME OF CHRONIC HEPATITIS B VIRUS (HBV) INFECTION BY AFFECTING CELLULAR AND VIRION GENE EXPRESSION, VIRAL REPLICATION AND THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA. HBV PERSISTS IN THE NUCLEUS OF INFECTED HEPATOCYTES AS A STABLE NON-INTEGRATED COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) WHICH FUNCTIONS AS A MINICHROMOSOME. THERE ARE TWO MAJOR FORMS OF HBV EPIGENETIC REGULATION: POSTTRANSLATIONAL MODIFICATION OF HISTONE PROTEINS ASSOCIATED WITH THE CCCDNA MINICHROMOSOME AND DNA METHYLATION OF VIRAL AND HOST GENOMES. THIS REVIEW EXPLORES HOW HBV CAN INTERPHASE WITH HOST EPIGENETIC REGULATION IN ORDER TO EVADE HOST DEFENCES AND TO PROMOTE ITS OWN SURVIVAL AND PERSISTENCE. WE FOCUS ON THE EFFECT OF CCCDNA BOUND-HISTONE MODIFICATIONS AND THE METHYLATION STATUS OF HBV DNA IN REGULATING VIRAL REPLICATION. INVESTIGATION OF HBV EPIGENETIC CONTROL HAS IMPORTANT CLINICAL CORRELATES WITH REGARDS TO THE DEVELOPMENT OF POTENTIAL THERAPEUTIC REGIMENS THAT WILL SUCCESSFULLY ERADICATE HBV INFECTION AND DEAL WITH HBV REACTIVATION IN THOSE UNDERGOING TREATMENT WITH DEMETHYLATING AGENTS. 2015 16 4131 40 MECHANISMS OF HBV-INDUCED HEPATOCELLULAR CARCINOMA. HEPATITIS B VIRUS (HBV) CONTRIBUTES TO HEPATOCELLULAR CARCINOMA (HCC) DEVELOPMENT THROUGH DIRECT AND INDIRECT MECHANISMS. HBV DNA INTEGRATION INTO THE HOST GENOME OCCURS AT EARLY STEPS OF CLONAL TUMOR EXPANSION AND INDUCES BOTH GENOMIC INSTABILITY AND DIRECT INSERTIONAL MUTAGENESIS OF DIVERSE CANCER-RELATED GENES. PROLONGED EXPRESSION OF THE VIRAL REGULATORY PROTEIN HBX AND/OR ALTERED VERSIONS OF THE PRES/S ENVELOPE PROTEINS DYSREGULATES CELL TRANSCRIPTION AND PROLIFERATION CONTROL AND SENSITIZES LIVER CELLS TO CARCINOGENIC FACTORS. ACCUMULATION OF PRES1 LARGE ENVELOPE PROTEINS AND/OR PRES2/S MUTANT PROTEINS ACTIVATES THE UNFOLD PROTEINS RESPONSE, THAT CAN CONTRIBUTE TO HEPATOCYTE TRANSFORMATION. EPIGENETIC CHANGES TARGETING THE EXPRESSION OF TUMOR SUPPRESSOR GENES OCCUR EARLY IN THE DEVELOPMENT OF HCC. A MAJOR ROLE IS PLAYED BY THE HBV PROTEIN, HBX, WHICH IS RECRUITED ON CELLULAR CHROMATIN AND MODULATES CHROMATIN DYNAMICS AT SPECIFIC GENE LOCI. COMPARED WITH TUMORS ASSOCIATED WITH OTHER RISK FACTORS, HBV-RELATED TUMORS HAVE A HIGHER RATE OF CHROMOSOMAL ALTERATIONS, P53 INACTIVATION BY MUTATIONS AND OVEREXPRESSION OF FETAL LIVER/HEPATIC PROGENITOR CELLS GENES. THE WNT/BETA-CATENIN PATHWAY IS ALSO OFTEN ACTIVATED BUT HBV-RELATED TUMORS DISPLAY A LOW RATE OF ACTIVATING BETA-CATENIN MUTATIONS. HBV-RELATED HCCS MAY ARISE ON NON-CIRRHOTIC LIVERS, FURTHER SUPPORTING THE NOTION THAT HBV PLAYS A DIRECT ROLE IN LIVER TRANSFORMATION BY TRIGGERING BOTH COMMON AND ETIOLOGY SPECIFIC ONCOGENIC PATHWAYS IN ADDITION TO STIMULATING THE HOST IMMUNE RESPONSE AND DRIVING LIVER CHRONIC NECRO-INFLAMMATION. 2016 17 4462 37 MOLECULAR MECHANISMS OF HBV-ASSOCIATED HEPATOCARCINOGENESIS. HEPATITIS B VIRUS (HBV) CONTRIBUTES TO HEPATOCELLULAR CARCINOMA (HCC) DEVELOPMENT THROUGH DIRECT AND INDIRECT MECHANISMS. HBV-DNA INTEGRATION INTO THE HOST GENOME OCCURS AT EARLY STEPS OF CLONAL TUMOR EXPANSION AND INDUCES BOTH GENOMIC INSTABILITY AND DIRECT INSERTIONAL MUTAGENESIS OF DIVERSE CANCER-RELATED GENES. PROLONGED EXPRESSION OF THE VIRAL REGULATORY PROTEIN HBX AND THE LARGE ENVELOPE PROTEIN DEREGULATE THE CELLULAR TRANSCRIPTION PROGRAM AND PROLIFERATION CONTROL AND SENSITIZE LIVER CELLS TO CARCINOGENIC FACTORS. EPIGENETIC CHANGES TARGETING THE EXPRESSION OF TUMOR SUPPRESSOR GENES OCCUR EARLY IN THE DEVELOPMENT OF HCC. A MAJOR ROLE IS PLAYED BY HBX THAT IS RECRUITED ON CELLULAR CHROMATIN AND MODULATES CHROMATIN DYNAMICS AT SPECIFIC GENE LOCI. COMPARED WITH TUMORS ASSOCIATED WITH OTHER RISK FACTORS, HBV-RELATED TUMORS HAVE A HIGHER RATE OF CHROMOSOMAL ALTERATIONS AND P53 INACTIVATION BY MUTATIONS, OVEREXPRESS FETAL LIVER/HEPATIC PROGENITOR CELLS GENES, AND SHOW A SPECIFIC ACTIVATION OF THE AKT PATHWAY. THE WNT/BETA-CATENIN PATHWAY IS ALSO OFTEN ACTIVATED, BUT HBV-RELATED TUMORS DISPLAY A LOW RATE OF ACTIVATING BETA-CATENIN MUTATIONS. ALL AVAILABLE EVIDENCE STRONGLY SUPPORTS THE NOTION THAT CHRONIC HBV INFECTION TRIGGERS BOTH COMMON AND ETIOLOGY-SPECIFIC ONCOGENIC PATHWAYS, THUS PLAYING A DIRECT ROLE BEYOND STIMULATION OF HOST IMMUNE RESPONSES AND CHRONIC NECROINFLAMMATORY LIVER DISEASE. 2013 18 819 35 CHARACTERIZATION OF A KDM5 SMALL MOLECULE INHIBITOR WITH ANTIVIRAL ACTIVITY AGAINST HEPATITIS B VIRUS. CHRONIC HEPATITIS B (CHB) IS A GLOBAL HEALTH CARE CHALLENGE AND A MAJOR CAUSE OF LIVER DISEASE. TO FIND NEW THERAPEUTIC AVENUES WITH A POTENTIAL TO FUNCTIONALLY CURE CHRONIC HEPATITIS B VIRUS (HBV) INFECTION, WE PERFORMED A FOCUSED SCREEN OF EPIGENETIC MODIFIERS TO IDENTIFY POTENTIAL INHIBITORS OF REPLICATION OR GENE EXPRESSION. FROM THIS WORK WE IDENTIFIED ISONICOTINIC ACID INHIBITORS OF THE HISTONE LYSINE DEMETHYLASE 5 (KDM5) WITH POTENT ANTI-HBV ACTIVITY. TO ENHANCE THE CELLULAR PERMEABILITY AND LIVER ACCUMULATION OF THE MOST POTENT KDM5 INHIBITOR IDENTIFIED (GS-080) AN ESTER PRODRUG WAS DEVELOPED (GS-5801) THAT RESULTED IN IMPROVED BIOAVAILABILITY AND LIVER EXPOSURE AS WELL AS AN INCREASED H3K4ME3:H3 RATIO ON CHROMATIN. GS-5801 TREATMENT OF HBV-INFECTED PRIMARY HUMAN HEPATOCYTES REDUCED THE LEVELS OF HBV RNA, DNA AND ANTIGEN. EVALUATION OF GS-5801 ANTIVIRAL ACTIVITY IN A HUMANIZED MOUSE MODEL OF HBV INFECTION, HOWEVER, DID NOT RESULT IN ANTIVIRAL EFFICACY, DESPITE ACHIEVING PHARMACODYNAMIC LEVELS OF H3K4ME3:H3 PREDICTED TO BE EFFICACIOUS FROM THE IN VITRO MODEL. HERE WE DISCUSS POTENTIAL REASONS FOR THE DISCONNECT BETWEEN IN VITRO AND IN VIVO EFFICACY, WHICH HIGHLIGHT THE TRANSLATIONAL DIFFICULTIES OF EPIGENETIC TARGETS FOR VIRAL DISEASES. 2022 19 94 35 A PLEIOTROPIC ROLE OF THE HEPATITIS B VIRUS CORE PROTEIN IN HEPATOCARCINOGENESIS. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS ONE OF THE MOST COMMON FACTORS ASSOCIATED WITH HEPATOCELLULAR CARCINOMA (HCC), WHICH IS THE SIXTH MOST PREVALENT CANCER AMONG ALL CANCERS WORLDWIDE. HOWEVER, THE PATHOGENESIS OF HBV-MEDIATED HEPATOCARCINOGENESIS IS UNCLEAR. EVIDENCE CURRENTLY AVAILABLE SUGGESTS THAT THE HBV CORE PROTEIN (HBC) PLAYS A POTENTIAL ROLE IN THE DEVELOPMENT OF HCC, SUCH AS THE HBV X PROTEIN. THE CORE PROTEIN, WHICH IS THE STRUCTURAL COMPONENT OF THE VIRAL NUCLEOCAPSID, CONTRIBUTES TO ALMOST EVERY STAGE OF THE HBV LIFE CYCLE AND OCCUPIES DIVERSE ROLES IN HBV REPLICATION AND PATHOGENESIS. RECENT STUDIES HAVE SHOWN THAT HBC WAS ABLE TO DISRUPT VARIOUS PATHWAYS INVOLVED IN LIVER CARCINOGENESIS: THE SIGNALING PATHWAYS IMPLICATED IN MIGRATION AND PROLIFERATION OF HEPATOMA CELLS, APOPTOSIS PATHWAYS, AND CELL METABOLIC PATHWAYS INDUCING THE DEVELOPMENT OF HCC; AND THE IMMUNE SYSTEM, THROUGH THE EXPRESSION AND PRODUCTION OF PROINFLAMMATORY CYTOKINES. IN ADDITION, HBC CAN MODULATE NORMAL FUNCTIONS OF HEPATOCYTES THROUGH DISRUPTING HUMAN HOST GENE EXPRESSION BY BINDING TO PROMOTER REGIONS. THIS HBV PROTEIN ALSO PROMOTES HCC METASTASIS THROUGH EPIGENETIC ALTERATIONS, SUCH AS MICRO-RNA. THIS REVIEW FOCUSES ON THE MOLECULAR PATHOGENESIS OF THE HBC PROTEIN IN HBV-INDUCED HCC. 2021 20 3253 36 HEPATITIS B VIRUS X PROTEIN ACCELERATES THE DEVELOPMENT OF HEPATOMA. THE CHRONIC INFECTION OF HEPATITIS B VIRUS (HBV) IS CLOSELY RELATED TO THE OCCURRENCE AND DEVELOPMENT OF HEPATOCELLULAR CARCINOMA (HCC). ACCUMULATED EVIDENCE HAS SHOWN THAT HBV X PROTEIN (HBX PROTEIN) IS A MULTIFUNCTIONAL REGULATOR WITH A CRUCIAL ROLE IN HEPATOCARCINOGENESIS. HOWEVER, INFORMATION ON THE MECHANISM BY WHICH HBV INDUCES HCC IS LACKING. THIS REVIEW FOCUSES ON THE PATHOLOGICAL FUNCTIONS OF HBX IN HBV-INDUCED HEPATOCARCINOGENESIS. AS A TRANSACTIVATOR, HBX CAN MODULATE NUCLEAR FACTOR KAPPA-LIGHT-CHAIN-ENHANCER OF ACTIVATED B CELLS (NF-KAPPAB) AND TRANSCRIPTION FACTOR AP-2. MOREOVER, HBX CAN AFFECT REGULATORY NON-CODING RNAS (NCRNAS) INCLUDING MICRORNAS AND LONG NCRNAS (LNCRNAS), SUCH AS MIRNA-205 AND HIGHLY UPREGULATED IN LIVER CANCER (HULC), RESPECTIVELY. HBX IS ALSO INVOLVED IN EPIGENETIC MODIFICATION, INCLUDING METHYLATION AND ACETYLATION. HBX INTERACTS WITH VARIOUS SIGNAL-TRANSDUCTION PATHWAYS, SUCH AS PROTEIN KINASE B/AKT, WNT/BETA-CATENIN, SIGNAL TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION, AND NF-KAPPAB PATHWAYS. MOREOVER, HBX AFFECTS CELLULAR FATE BY SHIFTING THE BALANCE TOWARD CELL SURVIVAL. HBX MAY LEAD TO THE LOSS OF APOPTOTIC FUNCTIONS OR DIRECTLY CONTRIBUTES TO ONCOGENESIS BY ACHIEVING TRANSFORMING FUNCTIONS, WHICH INDUCE HEPATOCARCINOGENESIS. ADDITIONALLY, HBX CAN MODULATE APOPTOSIS AND IMMUNE RESPONSE BY DIRECT OR INDIRECT INTERACTION WITH HOST FACTORS. WE CONCLUDE THAT HBX HASTENS THE DEVELOPMENT OF HEPATOMA. 2014