1 6523 122 TRANSCRIPTIONAL AND EPIGENETIC REGULATORY MECHANISMS AFFECTING HTLV-1 PROVIRUS. HUMAN T-CELL LEUKEMIA VIRUS TYPE 1 (HTLV-1) IS A RETROVIRUS ASSOCIATED WITH HUMAN DISEASES, SUCH AS ADULT T-CELL LEUKEMIA (ATL) AND HTLV-1-ASSOCIATED MYELOPATHY/TROPIC SPASTIC PARAPARESIS (HAM/TSP). AS A RETROVIRUS, ITS LIFE CYCLE INCLUDES A STEP WHERE HTLV-1 IS INTEGRATED INTO THE HOST GENOMIC DNA AND FORMS PROVIRAL DNA. IN THE CHRONIC PHASE OF THE INFECTION, HTLV?1 IS KNOWN TO PROLIFERATE AS A PROVIRUS VIA THE MITOTIC DIVISION OF THE INFECTED HOST CELLS. THERE ARE GENERALLY TENS OF THOUSANDS OF INFECTED CLONES WITHIN AN INFECTED INDIVIDUAL. THEY EXIST NOT ONLY IN PERIPHERAL BLOOD, BUT ALSO IN VARIOUS LYMPHOID ORGANS. VIRAL PROTEINS ENCODED IN HTLV-1 GENOME PLAY A ROLE IN THE PROLIFERATION AND SURVIVAL OF THE INFECTED CELLS. AS IS THE CASE WITH OTHER CHRONIC VIRAL INFECTIONS, HTLV-1 GENE EXPRESSION INDUCES THE ACTIVATION OF THE HOST IMMUNITY AGAINST THE VIRUS. THUS, THE TRANSCRIPTION FROM HTLV-1 PROVIRUS NEEDS TO BE CONTROLLED IN ORDER TO EVADE THE HOST IMMUNE SURVEILLANCE. THERE SHOULD BE A DYNAMIC AND COMPLEX REGULATION IN VIVO, WHERE AN EQUILIBRIUM BETWEEN VIRAL ANTIGEN EXPRESSION AND HOST IMMUNE SURVEILLANCE IS ACHIEVED. THE MECHANISMS REGULATING VIRAL GENE EXPRESSION FROM THE PROVIRUS ARE A KEY TO UNDERSTANDING THE PERSISTENT/LATENT INFECTION WITH HTLV-1 AND ITS PATHOGENESIS. IN THIS ARTICLE, WE WOULD LIKE TO REVIEW OUR CURRENT UNDERSTANDING ON THIS TOPIC. 2016 2 3340 48 HISTONE DEACETYLASE MEDIATED TRANSCRIPTIONAL ACTIVATION REDUCES PROVIRAL LOADS IN HTLV-1 ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS PATIENTS. EPIGENETIC MODIFICATIONS OF CHROMATIN MAY PLAY A ROLE IN MAINTAINING VIRAL LATENCY AND THUS PERSISTENCE OF THE HUMAN T-LYMPHOTROPIC VIRUS TYPE 1 (HTLV-1), WHICH IS RESPONSIBLE FOR HTLV-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS (HAM/TSP). A MAJOR DETERMINANT OF DISEASE PROGRESSION IS INCREASED PERIPHERAL BLOOD PROVIRAL LOAD (PVL), POSSIBLY VIA THE ACCUMULATION OF INFECTED CELLS IN THE CENTRAL NERVOUS SYSTEM (CNS) CREATING A DAMAGING INFLAMMATORY RESPONSE. CURRENT THERAPEUTIC APPROACHES THAT FOCUS ON REDUCING EITHER CELL PROLIFERATION, VIRAL REPLICATION, OR TISSUE INVASION ARE STILL UNSATISFACTORY. CONTRASTING WITH THESE INHIBITORY STRATEGIES, WE EVALUATED THE EFFICACY OF A NOVEL APPROACH AIMED, PARADOXICALLY, AT ACTIVATING VIRAL GENE EXPRESSION TO EXPOSE VIRUS-POSITIVE CELLS TO THE HOST IMMUNE RESPONSE. WE USED VALPROATE (VPA), A HISTONE DEACETYLASE INHIBITOR THAT HAS BEEN USED FOR DECADES AS A CHRONIC, SAFE TREATMENT FOR EPILEPTIC DISORDERS. BASED ON IN VITRO AND IN VIVO DATA, WE PROVIDE EVIDENCE THAT TRANSIENT ACTIVATION OF THE LATENT VIRAL RESERVOIR CAUSES ITS COLLAPSE, A PROCESS THAT MAY ALLEVIATE THE CONDITION OF HAM/TSP. THIS REPRESENTS THE FIRST SUCH APPROACH TO TREATING HAM/TSP, USING GENE ACTIVATION THERAPY TO TILT THE HOST-PATHOGEN BALANCE IN FAVOR OF AN EXISTING ANTIVIRAL RESPONSE. THIS TRIAL IS REGISTERED AT HTTP://CLINICALTRIALS.GOV/AS NO. NCT00519181. 2007 3 64 39 A HIGH-THROUGHPUT SCREENING ASSAY FOR SILENCING ESTABLISHED HIV-1 MACROPHAGE INFECTION IDENTIFIES NUCLEOSIDE ANALOGS THAT PERTURB H3K9ME3 ON PROVIRAL GENOMES. HIV-INFECTED MACROPHAGES ARE LONG-LIVED CELLS THAT REPRESENT A BARRIER TO FUNCTIONAL CURE. ADDITIONALLY, LOW-LEVEL VIRAL EXPRESSION BY CENTRAL NERVOUS SYSTEM (CNS) MACROPHAGES CONTRIBUTES TO NEUROCOGNITIVE DEFICITS THAT DEVELOP DESPITE ANTIRETROVIRAL THERAPY (ART). WE RECENTLY IDENTIFIED H3K9ME3 AS AN ATYPICAL EPIGENETIC MARK ASSOCIATED WITH CHRONIC HIV INFECTION IN MACROPHAGES. THUS, STRATEGIES ARE NEEDED TO SUPPRESS HIV-1 EXPRESSION IN MACROPHAGES, BUT THE UNIQUE MYELOID ENVIRONMENT AND THE RESPONSIBLE MACROPHAGE/CNS-TROPIC STRAINS REQUIRE CELL/STRAIN-SPECIFIC APPROACHES. HERE, WE GENERATED AN HIV-1 REPORTER VIRUS FROM A CNS-DERIVED STRAIN WITH INTACT AUXILIARY GENES EXPRESSING DESTABILIZED LUCIFERASE. WE EMPLOYED THIS REPORTER VIRUS IN POLYCLONAL INFECTION OF PRIMARY HUMAN MONOCYTE-DERIVED MACROPHAGES (MDM) FOR A HIGH-THROUGHPUT SCREEN (HTS) TO IDENTIFY COMPOUNDS THAT SUPPRESS VIRUS EXPRESSION FROM ESTABLISHED MACROPHAGE INFECTION. SCREENING ~6,000 KNOWN DRUGS AND COMPOUNDS YIELDED 214 HITS. A SECONDARY SCREEN WITH 10-DOSE TITRATION IDENTIFIED 24 MEETING CRITERIA FOR HIV-SELECTIVE ACTIVITY. USING THREE REPLICATION-COMPETENT CNS-DERIVED MACROPHAGE-TROPIC HIV-1 ISOLATES AND VIRAL GENE EXPRESSION READOUT IN MDM, WE CONFIRMED THE EFFECT OF THREE PURINE ANALOGS, NELARABINE, FLUDARABINE, AND ENTECAVIR, SHOWING THE SUPPRESSION OF HIV-1 EXPRESSION FROM ESTABLISHED MACROPHAGE INFECTION. NELARABINE INHIBITED THE FORMATION OF H3K9ME3 ON HIV GENOMES IN MACROPHAGES. THUS, THIS NOVEL HTS ASSAY CAN IDENTIFY SUPPRESSORS OF HIV-1 TRANSCRIPTION IN ESTABLISHED MACROPHAGE INFECTION, SUCH AS NUCLEOSIDE ANALOGS AND HDAC INHIBITORS, WHICH MAY BE LINKED TO H3K9ME3 MODIFICATION. THIS SCREEN MAY BE USEFUL TO IDENTIFY NEW METABOLIC AND EPIGENETIC AGENTS THAT AMELIORATE HIV-DRIVEN NEUROINFLAMMATION IN PEOPLE ON ART OR PREVENT VIRAL RECRUDESCENCE FROM MACROPHAGE RESERVOIRS IN STRATEGIES TO ACHIEVE ART-FREE REMISSION. IMPORTANCE MACROPHAGES INFECTED BY HIV-1 ARE A LONG-LIVED RESERVOIR AND A BARRIER IN CURRENT EFFORTS TO ACHIEVE HIV CURE AND ALSO CONTRIBUTE TO NEUROCOGNITIVE COMPLICATIONS IN PEOPLE DESPITE ANTIRETROVIRAL THERAPY (ART). SILENCING HIV EXPRESSION IN THESE CELLS WOULD BE OF GREAT VALUE, BUT THE REGULATION OF HIV-1 IN MACROPHAGES DIFFERS FROM T CELLS. WE DEVELOPED A NOVEL HIGH-THROUGHPUT SCREEN FOR COMPOUNDS THAT CAN SILENCE ESTABLISHED INFECTION OF PRIMARY MACROPHAGES, AND IDENTIFIED AGENTS THAT DOWNREGULATE VIRUS EXPRESSION AND ALTER PROVIRUS EPIGENETIC PROFILES. THE SIGNIFICANCE OF THIS ASSAY IS THE POTENTIAL TO IDENTIFY NEW DRUGS THAT ACT IN THE UNIQUE MACROPHAGE ENVIRONMENT ON RELEVANT VIRAL STRAINS, WHICH MAY CONTRIBUTE TO ADJUNCTIVE TREATMENT FOR HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS AND/OR PREVENT VIRAL REBOUND IN EFFORTS TO ACHIEVE ART-FREE REMISSION OR CURE. 2023 4 6002 34 THE ADAPTIVE BACTERIAL IMMUNE SYSTEM CRISPR-CAS AND ITS THERAPEUTIC POTENTIAL. THE BACTERIAL CRISPR-CAS-SYSTEM IS AN ADAPTIVE AND INHERITABLE IMMUNE SYSTEM FOR THE DEFENSE AGAINST INVASIVE GENETIC ELEMENTS SUCH AS VIRAL DNA OR PLASMIDS. CRISPR-CAS IMMUNITY ACTS BY INTEGRATING SHORT SEQUENCES OF NON-SELF DNA IN THE CELL'S CRISPR LOCUS WHICH ALLOWS THE CELL TO RECOGNIZE, TO REMEMBER AND TO DESTROY THE INVASIVE ELEMENT. IN THE LAST YEARS THE TYPE-II-SYSTEM CRISPR-CAS9 WAS DEVELOPED AS A POWERFUL AND UNIVERSAL TOOL FOR THE SEQUENCE-SPECIFIC MODIFICATION OF THE GENOME ALSO KNOWN AS GENOME EDITING. TYPE-II-SYSTEMS RELY SOLELY ON ONE SINGLE PROTEIN, CAS9, AND A NON-CODING, TRANS-ACTIVATING RNA THAT LEADS THE CAS9 PROTEIN TO ITS TARGET DNA. THE RNA-GUIDED MOLECULAR SCISSOR CAS9 IS PREDESTINATED TO CORRECT MUTATED GENES IN LINE WITH A GENE THERAPY AND TO HEAL CHRONIC DISEASES LIKE HIV INFECTIONS OR VIRUS-INDUCED FORMS OF CANCER VIA DELETING VIRAL DNA THAT IS INTEGRATED AS A PROVIRUS IN THE HOST'S GENOME. IN ADDITION, CATALYTICALLY INACTIVE CAS9 VARIANTS (DCAS9) FUSED TO EFFECTOR DOMAINS CAN BE USED TO SPECIFICALLY TAG GENOME SECTIONS, REGULATE GENE EXPRESSION AND MODIFY EPIGENETIC MARKERS. 2017 5 6789 27 [CURRENT STATUS OF ATL RESEARCH: EFFORTS FOR PREVENTION AND PRECISION MEDICINE FOR ATL]. THE INTRODUCTION OF NEW AGENTS AND HEMATOPOIETIC STEM CELL TRANSPLANTATION INTO THE TREATMENT OF ATL HAS ACTIVATED ITS CLINICAL RESEARCH. HOWEVER, THE PROGNOSIS OF ATL REMAINS POOR COMPARED WITH THOSE OF OTHER LEUKEMIAS AND LYMPHOMAS. THUS, SEEMINGLY WE HAVE TO RECONSIDER A NEW STRATEGY OF ATL THERAPY BASED ON ITS UNIQUE CHARACTERISTICS. HTLV-1 INFECTION OF T CELLS RESULTS IN CLONAL PROLIFERATION OF INFECTED CELLS THAT ACCUMULATE GENETIC AND EPIGENETIC ABNORMALITIES BEFORE THE ONSET OF ATL. THEREFORE, THE TREATMENT STRATEGY SHOULD INCLUDE THE PREVENTION OF HTLV-1 INFECTION AND ATL DEVELOPMENT IN ADDITION TO PRECISION MEDICINE BASED ON THE STRATIFICATION OF ATL CASES BY BIOMARKERS THAT DISCRIMINATE CLINICAL STAGES OF ATL. I SUMMARIZE HERE THE RECENT PROGRESS IN ATL RESEARCH FOCUSING ON THE BIOMOLECULAR ABNORMALITIES THAT LEAD TO CLONAL EXPANSION AND MALIGNANT TRANSFORMATION OF HTLV-1-INFECTED T CELLS. APPARENTLY, ONE OF THE BASES FOR THE PREVENTION OF ATL IS TO ESTABLISH A DISEASE ENTITY OF "CHRONIC ACTIVE HTLV-1 INFECTION" THAT DEFINES HIGH-RISK CARRIERS FOR ATL DEVELOPMENT AND ENABLES PREVENTIVE INTERVENTION. 2017 6 787 30 CELLS OF ADULT T-CELL LEUKEMIA EVADE HTLV-1 TAX/NF-KAPPAB HYPERACTIVATION-INDUCED SENESCENCE. HUMAN T-CELL LEUKEMIA VIRUS TYPE 1 (HTLV-1) IS THE ETIOLOGICAL AGENT OF ADULT T-CELL LEUKEMIA/LYMPHOMA (ATL). THE HTLV-1 VIRAL TRANS-ACTIVATOR/ONCOPROTEIN TAX IS A MAJOR DRIVER OF ATL, YET IT INDUCES RAPID P21(CIP1/WAF1) (P21)- AND P27(KIP1)-MEDIATED CELLULAR SENESCENCE THROUGH CONSTITUTIVE ACTIVATION (HYPERACTIVATION) OF NF-KAPPAB. ALTHOUGH CONSTITUTIVE NF-KAPPAB ACTIVATION IS A COMMON FEATURE OF T/B-CELL LEUKEMIA/LYMPHOMA, INCLUDING ATL, IT IS NOT KNOWN HOW ATL CELLS MAINTAIN CHRONIC NF-KAPPAB ACTIVATION WITHOUT UNDERGOING SENESCENCE. HERE, WE DEMONSTRATE THAT, IN CONTRAST TO HTLV-1(-) T-CELL LINES, ATL CELL LINES NO LONGER UNDERGO TAX-INDUCED SENESCENCE. ALTHOUGH TAX(+) AND TAX(-) ATL CELL LINES SHOWED SIGNATURES OF CONSTITUTIVE NF-KAPPAB ACTIVATION, THEIR ABILITY TO PROGRESS THROUGH THE CELL CYCLE WAS UNAFFECTED. IN SOME CASES, ATL CELL LINES CONTINUED TO PROLIFERATE DESPITE SIGNIFICANT UPREGULATION OF P21; ADDITIONALLY, MANY CELL LINES DISPLAYED ALTERED EXPRESSION OF G1 AND G1/S CYCLINS, PARTICULARLY OVEREXPRESSION OF CYCLIN D2. WE PROPOSE THAT, DURING THE COURSE OF ATL DEVELOPMENT, LEUKEMIA CELLS ACQUIRE GENETIC/EPIGENETIC CHANGES THAT CAN MITIGATE THE SENESCENCE RESPONSE TRIGGERED BY NF-KAPPAB HYPERACTIVATION. RESTORING THE NF-KAPPAB-INDUCED SENESCENCE RESPONSE WOULD LIKELY HELP TO CONTROL THE DEVELOPMENT AND PROGRESSION OF ATL AND SIMILAR LYMPHOID MALIGNANCIES. 2019 7 2143 31 EPIGENETIC LANDSCAPE OF HIV-1 INFECTION IN PRIMARY HUMAN MACROPHAGE. HUMAN IMMUNODEFICIENCY VIRUS (HIV)-INFECTED MACROPHAGES ARE LONG-LIVED CELLS THAT SUSTAIN PERSISTENT VIRUS EXPRESSION, WHICH IS BOTH A BARRIER TO VIRAL ERADICATION AND CONTRIBUTOR TO NEUROLOGICAL COMPLICATIONS IN PATIENTS DESPITE ANTIRETROVIRAL THERAPY (ART). TO BETTER UNDERSTAND THE REGULATION OF HIV-1 IN MACROPHAGES, WE COMPARED HIV-INFECTED PRIMARY HUMAN MONOCYTE-DERIVED MACROPHAGES (MDM) TO ACUTELY INFECTED PRIMARY CD4 T CELLS AND JURKAT CELLS LATENTLY INFECTED WITH HIV (JLAT 8.4). HIV GENOMES IN MDM WERE ACTIVELY TRANSCRIBED DESPITE ENRICHMENT WITH HETEROCHROMATIN-ASSOCIATED H3K9ME3 ACROSS THE COMPLETE HIV GENOME IN COMBINATION WITH ELEVATED ACTIVATION MARKS OF H3K9AC AND H3K27AC AT THE LONG TERMINAL REPEAT (LTR). MACROPHAGE PATTERNS CONTRASTED WITH JLAT CELLS, WHICH SHOWED CONVENTIONAL BIVALENT H3K4ME3/H3K27ME3, AND ACUTELY INFECTED CD4 T CELLS, WHICH SHOWED AN INTERMEDIATE EPIGENOTYPE. 5'-METHYLCYTOSINE (5MC) WAS ENRICHED ACROSS THE HIV GENOME IN LATENTLY INFECTED JLAT CELLS, WHILE 5'-HYDROXYMETHYLCYTOSINE (5HMC) WAS ENRICHED IN CD4 CELLS AND MDMS. HIV INFECTION INDUCED MULTINUCLEATION OF MDMS ALONG WITH DNA DAMAGE-ASSOCIATED P53 PHOSPHORYLATION, AS WELL AS LOSS OF TET2 AND THE NUCLEAR REDISTRIBUTION OF 5-HYDOXYMETHYLATION. TAKEN TOGETHER, OUR FINDINGS SUGGEST THAT HIV INDUCES A UNIQUE MACROPHAGE NUCLEAR AND TRANSCRIPTIONAL PROFILE, AND VIRAL GENOMES ARE MAINTAINED IN A NONCANONICAL BIVALENT EPIGENETIC STATE. IMPORTANCE MACROPHAGES SERVE AS A RESERVOIR FOR LONG-TERM PERSISTENCE AND CHRONIC PRODUCTION OF HIV. WE FOUND AN ATYPICAL EPIGENETIC CONTROL OF HIV IN MACROPHAGES MARKED BY HETEROCHROMATIC H3K9ME3 DESPITE ACTIVE VIRAL TRANSCRIPTION. HIV INFECTION INDUCED CHANGES IN MACROPHAGE NUCLEAR MORPHOLOGY AND EPIGENETIC REGULATORY FACTORS. THESE FINDINGS MAY IDENTIFY NEW MECHANISMS TO CONTROL CHRONIC HIV EXPRESSION IN INFECTED MACROPHAGES. 2022 8 3113 42 GERMINAL EPIMUTATION OF FRAGILE HISTIDINE TRIAD (FHIT) GENE IS ASSOCIATED WITH PROGRESSION TO ACUTE AND CHRONIC ADULT T-CELL LEUKEMIA DISEASES. BACKGROUND: HUMAN T CELL LEUKEMIA VIRUS TYPE 1 (HTLV-I) IS ETIOLOGICALLY LINKED TO ADULT T CELL LEUKEMIA/LYMPHOMA (ATL) AND AN INFLAMMATORY NEURODEGENERATIVE DISEASE CALLED HTLV-I-ASSOCIATED MYELOPATHY OR TROPICAL SPASTIC PARAPARESIS (HAM/TSP). THE EXACT GENETIC OR EPIGENETIC EVENTS AND/OR ENVIRONMENTAL FACTORS THAT INFLUENCE THE DEVELOPMENT OF ATL, OR HAM/TSP DISEASES ARE LARGELY UNKNOWN. THE TUMOR SUPPRESSOR GENE, FRAGILE HISTIDINE TRIAD DIADENOSINE TRIPHOSPHATASE (FHIT), IS FREQUENTLY LOST IN CANCER THROUGH EPIGENETIC MODIFICATIONS AND/OR DELETION. FHIT IS A TUMOR SUPPRESSOR ACTING AS GENOME CARETAKER BY REGULATING CELLULAR DNA REPAIR. INDEED, FHIT LOSS LEADS TO REPLICATIVE STRESS AND ACCUMULATION OF DOUBLE DNA STRAND BREAKS. THEREFORE, LOSS OF FHIT EXPRESSION PLAYS A KEY ROLE IN CELLULAR TRANSFORMATION. METHODS: HERE, WE STUDIED OVER 400 SAMPLES FROM HTLV-I-INFECTED INDIVIDUALS WITH ATL, TSP/HAM, OR ASYMPTOMATIC CARRIERS (AC) FOR FHIT LOSS AND EXPRESSION. WE EXAMINED THE EPIGENETIC STATUS OF FHIT THROUGH METHYLATION SPECIFIC PCR AND BISULFITE SEQUENCING; AND CORRELATED THESE RESULTS TO FHIT EXPRESSION IN PATIENT SAMPLES. RESULTS: WE FOUND THAT EPIGENETIC ALTERATION OF FHIT IS SPECIFICALLY FOUND IN CHRONIC AND ACUTE ATL BUT IS ABSENT IN ASYMPTOMATIC HTLV-I CARRIERS AND TSP/HAM PATIENTS' SAMPLES. FURTHERMORE, THE EXTENT OF FHIT METHYLATION IN ATL PATIENTS WAS QUANTITATIVELY COMPARABLE IN VIRUS-INFECTED AND VIRUS NON-INFECTED CELLS. WE ALSO FOUND THAT LONGITUDINAL HTLV-I CARRIERS THAT PROGRESSED TO SMOLDERING ATL AND DESCENDANTS OF ATL PATIENTS HARBOR FHIT METHYLATION. CONCLUSIONS: THESE RESULTS SUGGEST THAT GERMINAL EPIGENETIC MUTATION OF FHIT REPRESENTS A PREEXISTING MARK PREDISPOSING TO THE DEVELOPMENT OF ATL DISEASES. THESE FINDINGS HAVE IMPORTANT CLINICAL IMPLICATIONS AS PATIENTS WITH ACUTE ATL ARE RARELY CURED. OUR STUDY SUGGESTS AN ALTERNATIVE STRATEGY TO THE CURRENT "WAIT AND SEE APPROACH" IN THAT EARLY SCREENING OF HTLV-I-INFECTED INDIVIDUALS FOR GERMINAL EPIMUTATION OF FHIT AND EARLY TREATMENT MAY OFFER SIGNIFICANT CLINICAL BENEFITS. 2021 9 2115 27 EPIGENETIC HETEROGENEITY IN HIV-1 LATENCY ESTABLISHMENT. DESPITE PROLONGED ANTIRETROVIRAL THERAPY, HIV-1 PERSISTS AS TRANSCRIPTIONALLY INACTIVE PROVIRUSES. THE HIV-1 LATENCY REMAINS A PRINCIPAL OBSTACLE IN CURING AIDS. IT IS IMPORTANT TO UNDERSTAND MECHANISMS BY WHICH HIV-1 LATENCY IS ESTABLISHED TO MAKE THE LATENT RESERVOIR SMALLER. WE PRESENT A MOLECULAR CHARACTERIZATION OF DISTINCT POPULATIONS AT AN EARLY PHASE OF INFECTION. WE DEVELOPED AN ORIGINAL DUAL-COLOR REPORTER VIRUS TO MONITOR LTR KINETICS FROM ESTABLISHMENT TO MAINTENANCE STAGE. WE FOUND THAT THERE ARE TWO WAYS OF LATENCY ESTABLISHMENT I.E., BY IMMEDIATE SILENCING AND SLOW INACTIVATION FROM ACTIVE INFECTION. HISTONE COVALENT MODIFICATIONS, PARTICULARLY POLYCOMB REPRESSIVE COMPLEX 2 (PRC2)-MEDIATED H3K27 TRIMETHYLATION, APPEARED TO DOMINATE VIRAL TRANSCRIPTION AT THE EARLY PHASE. PRC2 ALSO CONTRIBUTES TO TIME-DEPENDENT LTR DORMANCY IN THE CHRONIC PHASE OF THE INFECTION. SIGNIFICANT DIFFERENCES IN SENSITIVITY AGAINST SEVERAL STIMULI WERE OBSERVED BETWEEN THESE TWO DISTINCT POPULATIONS. THESE RESULTS WILL EXPAND OUR UNDERSTANDING OF HETEROGENEOUS ESTABLISHMENT OF HIV-1 LATENCY POPULATIONS. 2015 10 4760 40 NOVEL TREATMENTS OF ADULT T CELL LEUKEMIA LYMPHOMA. ADULT T CELL LEUKEMIA-LYMPHOMA (ATL) IS AN AGGRESSIVE MALIGNANCY SECONDARY TO CHRONIC INFECTION WITH THE HUMAN T CELL LEUKEMIA VIRUS TYPE I (HTLV-I) RETROVIRUS. ATL CARRIES A DISMAL PROGNOSIS. ATL CLASSIFIES INTO FOUR SUBTYPES (ACUTE, LYMPHOMA, CHRONIC, AND SMOLDERING) WHICH DISPLAY DIFFERENT CLINICAL FEATURES, PROGNOSIS AND RESPONSE TO THERAPY, HENCE REQUIRING DIFFERENT CLINICAL MANAGEMENT. SMOLDERING AND CHRONIC SUBTYPES RESPOND WELL TO ANTIRETROVIRAL THERAPY USING THE COMBINATION OF ZIDOVUDINE (AZT) AND INTERFERON-ALPHA (IFN) WITH A SIGNIFICANT PROLONGATION OF SURVIVAL. CONVERSELY, THE WATCH AND WAIT STRATEGY OR CHEMOTHERAPY FOR THESE INDOLENT SUBTYPES ALLIES WITH A POOR LONG-TERM OUTCOME. ACUTE ATL IS ASSOCIATED WITH CHEMO-RESISTANCE AND DISMAL PROGNOSIS. LYMPHOMA SUBTYPES RESPOND BETTER TO INTENSIVE CHEMOTHERAPY BUT SURVIVAL REMAINS POOR. ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) RESULTS IN LONG-TERM SURVIVAL IN ROUGHLY ONE THIRD OF TRANSPLANTED PATIENTS BUT ONLY A SMALL PERCENTAGE OF PATIENTS CAN MAKE IT TO TRANSPLANT. OVERALL, CURRENT TREATMENTS OF AGGRESSIVE ATL ARE NOT SATISFACTORY. PROGNOSIS OF REFRACTORY OR RELAPSED PATIENTS IS DISMAL WITH SOME ENCOURAGING RESULTS WHEN USING LENALIDOMIDE OR MOGAMULIZUMAB. TO OVERCOME RESISTANCE AND PREVENT RELAPSE, PRECLINICAL OR PILOT CLINICAL STUDIES USING TARGETED THERAPIES SUCH AS ARSENIC/IFN, MONOCLONAL ANTIBODIES, EPIGENETIC THERAPIES ARE PROMISING BUT WARRANT FURTHER CLINICAL INVESTIGATION. ANTI-ATL VACCINES INCLUDING TAX PEPTIDE-PULSED DENDRITIC CELLS, INDUCED TAX-SPECIFIC CTL RESPONSES IN ATL PATIENTS. FINALLY, BASED ON THE PROGRESS IN UNDERSTANDING THE PATHOPHYSIOLOGY OF ATL, AND THE RISK-ADAPTED TREATMENT APPROACHES TO DIFFERENT ATL SUBTYPES, TREATMENT STRATEGIES OF ATL SHOULD TAKE INTO ACCOUNT THE HOST IMMUNE RESPONSES AND THE HOST MICROENVIRONMENT INCLUDING HTLV-1 INFECTED NON-MALIGNANT CELLS. HEREIN, WE WILL PROVIDE A SUMMARY OF NOVEL TREATMENTS OF ATL IN VITRO, IN VIVO, AND IN EARLY CLINICAL TRIALS. 2020 11 1239 32 CURE AND LONG-TERM REMISSION STRATEGIES. THE MAJORITY OF VIRALLY SUPPRESSED INDIVIDUALS WILL EXPERIENCE RAPID VIRAL REBOUND UPON ANTIRETROVIRAL THERAPY (ART) INTERRUPTION, PROVIDING A STRONG RATIONALE FOR THE DEVELOPMENT OF CURE STRATEGIES. MOREOVER, DESPITE ART VIROLOGICAL CONTROL, HIV INFECTION IS STILL ASSOCIATED WITH CHRONIC IMMUNE ACTIVATION, INFLAMMATION, COMORBIDITIES, AND ACCELERATED AGING. THESE EFFECTS ARE BELIEVED TO BE DUE, IN PART, TO LOW-GRADE PERSISTENT TRANSCRIPTION AND TRICKLING PRODUCTION OF VIRAL PROTEINS FROM THE POOL OF LATENT PROVIRUSES CONSTITUTING THE VIRAL RESERVOIR. IN RECENT YEARS THERE HAS BEEN AN INCREASING INTEREST IN DEVELOPING WHAT HAS BEEN TERMED A FUNCTIONAL CURE FOR HIV. THIS APPROACH ENTAILS THE LONG-TERM, DURABLE CONTROL OF VIRAL EXPRESSION IN THE ABSENCE OF THERAPY, PREVENTING DISEASE PROGRESSION AND TRANSMISSION, DESPITE THE PRESENCE OF DETECTABLE INTEGRATED PROVIRUSES. ONE SUCH STRATEGY, THE BLOCK-AND-LOCK APPROACH FOR A FUNCTIONAL CURE, PROPOSES THE EPIGENETIC SILENCING OF PROVIRAL EXPRESSION, LOCKING THE VIRUS IN A PROFOUND LATENT STATE, FROM WHICH REACTIVATION IS VERY UNLIKELY. THE PROOF-OF-CONCEPT FOR THIS APPROACH WAS DEMONSTRATED WITH THE USE OF A SPECIFIC SMALL MOLECULE TARGETING HIV TRANSCRIPTION. HERE WE REVIEW THE PRINCIPLES BEHIND THE BLOCK-AND-LOCK APPROACH AND SOME OF THE ADDITIONAL STRATEGIES PROPOSED TO SILENCE HIV EXPRESSION. 2022 12 3938 29 LNC(ING)RNAS TO THE "SHOCK AND KILL" STRATEGY FOR HIV-1 CURE. THE ADVENT OF ANTIRETROVIRAL THERAPY ALMOST 25 YEARS AGO HAS TRANSFORMED HIV-1 INFECTION INTO A MANAGEABLE CHRONIC CONDITION, ALBEIT STILL INCURABLE. THE INABILITY OF THE TREATMENT REGIMEN TO ELIMINATE LATENTLY INFECTED CELLS THAT HARBOR THE VIRUS IN AN EPIGENETICALLY SILENT STATE POSES A MAJOR HURDLE. CURRENT CURE APPROACHES ARE FOCUSED ON A "SHOCK AND KILL" STRATEGY THAT USES LATENCY-REVERSING AGENTS TO CHEMICALLY REVERSE THE PROVIRAL QUIESCENCE IN LATENTLY INFECTED CELLS, FOLLOWED BY IMMUNE-MEDIATED CLEARANCE OF REACTIVATED CELLS. TO DATE, HUNDREDS OF COMPOUNDS HAVE BEEN INVESTIGATED FOR VIRAL REACTIVATION, YET NONE HAS RESULTED IN A FUNCTIONAL CURE. THE INSUFFICIENCY OF THESE LATENCY-REVERSING AGENTS (LRAS) ALONE INDICATES A CRITICAL NEED FOR ADDITIONAL, ALTERNATE APPROACHES SUCH AS GENETIC MANIPULATION. LONG NON-CODING RNAS (LNCRNAS) ARE AN EMERGING CLASS OF REGULATORY RNAS WITH FUNCTIONAL ROLES IN MANY CELLULAR PROCESSES, INCLUDING EPIGENETIC MODULATION. A NUMBER OF LNCRNAS HAVE ALREADY BEEN IMPLICATED TO PLAY IMPORTANT ROLES IN HIV-1 LATENCY AND, AS SUCH, PHARMACOLOGICAL MODULATION OF LNCRNAS CONSTITUTES A RATIONAL ALTERNATIVE APPROACH IN HIV-1 CURE RESEARCH. IN THIS REVIEW, WE DISCUSS THE CURRENT STATE OF KNOWLEDGE OF THE ROLE OF LNCRNAS IN HIV-1 INFECTION AND EXPLORE THE SCOPE FOR A LNCRNA-MEDIATED GENETIC APPROACH WITHIN THE SHOCK AND KILL STRATEGY OF HIV-1 CURE. 2021 13 2915 32 GENE THERAPY FOR CHRONIC HBV-CAN WE ELIMINATE CCCDNA? CHRONIC INFECTION WITH THE HEPATITIS B VIRUS (HBV) IS A GLOBAL HEALTH CONCERN AND ACCOUNTS FOR APPROXIMATELY 1 MILLION DEATHS ANNUALLY. AMONGST OTHER LIMITATIONS OF CURRENT ANTI-HBV TREATMENT, FAILURE TO ELIMINATE THE VIRAL COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) AND EMERGENCE OF RESISTANCE REMAIN THE MOST WORRISOME. VIRAL REBOUND FROM LATENT EPISOMAL CCCDNA RESERVOIRS OCCURS FOLLOWING CESSATION OF THERAPY, PATIENT NON-COMPLIANCE, OR THE DEVELOPMENT OF ESCAPE MUTANTS. SIMULTANEOUS VIRAL CO-INFECTIONS, SUCH AS BY HIV-1, FURTHER COMPLICATE THERAPEUTIC INTERVENTIONS. THESE CHALLENGES HAVE PROMPTED DEVELOPMENT OF NOVEL TARGETED HEPATITIS B THERAPIES. GIVEN THE EASE WITH WHICH HIGHLY SPECIFIC AND POTENT NUCLEIC ACID THERAPEUTICS CAN BE RATIONALLY DESIGNED, GENE THERAPY HAS GENERATED INTEREST FOR ANTIVIRAL APPLICATION. GENE THERAPY STRATEGIES DEVELOPED FOR HBV INCLUDE GENE SILENCING BY HARNESSING RNA INTERFERENCE, TRANSCRIPTIONAL INHIBITION THROUGH EPIGENETIC MODIFICATION OF TARGET DNA, GENOME EDITING BY DESIGNER NUCLEASES, AND IMMUNE MODULATION WITH CYTOKINES. DNA-BINDING DOMAINS AND EFFECTORS BASED ON THE ZINC FINGER (ZF), TRANSCRIPTION ACTIVATOR-LIKE EFFECTOR (TALE), AND CLUSTERED REGULARLY INTERSPACED SHORT PALINDROMIC REPEAT (CRISPR) SYSTEMS ARE REMARKABLY WELL SUITED TO TARGETING EPISOMAL CCCDNA. THIS REVIEW DISCUSSES RECENT DEVELOPMENTS AND CHALLENGES FACING THE FIELD OF ANTI-HBV GENE THERAPY, ITS POTENTIAL CURATIVE SIGNIFICANCE AND THE PROGRESS TOWARDS CLINICAL APPLICATION. 2018 14 3380 31 HIV-1 INFECTION OF GENETICALLY ENGINEERED IPSC-DERIVED CENTRAL NERVOUS SYSTEM-ENGRAFTED MICROGLIA IN A HUMANIZED MOUSE MODEL. THE CENTRAL NERVOUS SYSTEM (CNS) IS A MAJOR HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 RESERVOIR. MICROGLIA ARE THE PRIMARY TARGET CELL OF HIV-1 INFECTION IN THE CNS. CURRENT MODELS HAVE NOT ALLOWED THE PRECISE MOLECULAR PATHWAYS OF ACUTE AND CHRONIC CNS MICROGLIAL INFECTION TO BE TESTED WITH IN VIVO GENETIC METHODS. HERE, WE DESCRIBE A NOVEL HUMANIZED MOUSE MODEL UTILIZING HUMAN-INDUCED PLURIPOTENT STEM CELL-DERIVED MICROGLIA TO XENOGRAFT INTO MURINE HOSTS. THESE MICE ARE ADDITIONALLY ENGRAFTED WITH HUMAN PERIPHERAL BLOOD MONONUCLEAR CELLS THAT SERVED AS A MEDIUM TO ESTABLISH A PERIPHERAL INFECTION THAT THEN SPREAD TO THE CNS MICROGLIA XENOGRAFT, MODELING A TRANS-BLOOD-BRAIN BARRIER ROUTE OF ACUTE CNS HIV-1 INFECTION WITH HUMAN TARGET CELLS. THE APPROACH IS COMPATIBLE WITH IPSC GENETIC ENGINEERING, INCLUDING INSERTING TARGETED TRANSGENIC REPORTER CASSETTES TO TRACK THE XENOGRAFTED HUMAN CELLS, ENABLING THE TESTING OF NOVEL TREATMENT AND VIRAL TRACKING STRATEGIES IN A COMPARATIVELY SIMPLE AND COST-EFFECTIVE WAY VIVO MODEL FOR NEUROHIV. IMPORTANCE: OUR MOUSE MODEL IS A POWERFUL TOOL FOR INVESTIGATING THE GENETIC MECHANISMS GOVERNING CNS HIV-1 INFECTION AND LATENCY IN THE CNS AT A SINGLE-CELL LEVEL. A MAJOR ADVANTAGE OF OUR MODEL IS THAT IT USES IPSC-DERIVED MICROGLIA, WHICH ENABLES HUMAN GENETICS, INCLUDING GENE FUNCTION AND THERAPEUTIC GENE MANIPULATION, TO BE EXPLORED IN VIVO , WHICH IS MORE CHALLENGING TO STUDY WITH CURRENT HEMATOPOIETIC STEM CELL-BASED MODELS FOR NEUROHIV. OUR TRANSGENIC TRACING OF XENOGRAFTED HUMAN CELLS WILL PROVIDE A QUANTITATIVE MEDIUM TO DEVELOP NEW MOLECULAR AND EPIGENETIC STRATEGIES FOR REDUCING THE HIV-1 LATENT RESERVOIR AND TO TEST THE IMPACT OF THERAPEUTIC INFLAMMATION-TARGETING DRUG INTERVENTIONS ON CNS HIV-1 LATENCY. 2023 15 2073 39 EPIGENETIC CROSSTALK IN CHRONIC INFECTION WITH HIV-1. HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1) REPLICATES THROUGH THE INTEGRATION OF ITS VIRAL DNA INTO THE GENOME OF HUMAN IMMUNE TARGET CELLS. CHRONICALLY INFECTED INDIVIDUALS THUS CARRY A GENOMIC BURDEN OF VIRUS-DERIVED SEQUENCES THAT PERSISTS THROUGH ANTIRETROVIRAL THERAPY. THIS BURDEN CONSISTS OF A SMALL FRACTION OF INTACT, BUT TRANSCRIPTIONALLY SILENCED, I.E. LATENT, VIRAL GENOMES AND A DOMINANT FRACTION OF DEFECTIVE SEQUENCES. REMARKABLY, ALL VIRAL-DERIVED SEQUENCES ARE SUBJECT TO INTERACTION WITH HOST CELLULAR PHYSIOLOGY AT VARIOUS LEVELS. IN THIS REVIEW, WE FOCUS ON EPIGENETIC ASPECTS OF THIS INTERACTION. WE PROVIDE A COMPREHENSIVE OVERVIEW OF HOW EPIGENETIC MECHANISMS CONTRIBUTE TO ESTABLISHMENT AND MAINTENANCE OF HIV-1 GENE REPRESSION DURING LATENCY. WE FURTHERMORE SUMMARIZE FINDINGS INDICATING THAT HIV-1 INFECTION LEADS TO CHANGES IN THE EPIGENOME OF TARGET AND BYSTANDER IMMUNE CELLS. FINALLY, WE DISCUSS HOW AN IMPROVED UNDERSTANDING OF EPIGENETIC FEATURES AND MECHANISMS INVOLVED IN HIV-1 INFECTION COULD BE EXPLOITED FOR CLINICAL USE. 2020 16 4849 32 OPIOID-MEDIATED HIV-1 IMMUNOPATHOGENESIS. DESPITE THE ABILITY OF COMBINATION ANTIRETROVIRAL THERAPY TO DRAMATICALLY SUPPRESS VIREMIA, THE BRAIN CONTINUES TO BE A RESERVOIR OF HIV-1 LOW-LEVEL REPLICATION. ADDING FURTHER COMPLEXITY TO THIS IS THE COMORBIDITY OF DRUG ABUSE WITH HIV-1 ASSOCIATED NEUROCOGNITIVE DISORDERS AND NEUROHIV. AMONG SEVERAL ABUSED DRUGS, THE USE OF OPIATES IS HIGHLY PREVALENT IN HIV-1 INFECTED INDIVIDUALS, BOTH AS AN ABUSED DRUG AS WELL AS FOR PAIN MANAGEMENT. OPIOIDS AND THEIR RECEPTORS HAVE ATTAINED NOTABLE ATTENTION OWING TO THEIR ABILITY TO MODULATE IMMUNE FUNCTIONS, IN TURN, IMPACTING DISEASE PROGRESSION. VARIOUS CELL CULTURE, ANIMAL AND HUMAN STUDIES HAVE IMPLICATED THE ROLE OF OPIOIDS AND THEIR RECEPTORS IN MODULATING VIRAL REPLICATION AND VIRUS-MEDIATED PATHOLOGY BOTH POSITIVELY AND NEGATIVELY. FURTHER, THE COMBINATORIAL EFFECTS OF HIV-1/HIV-1 PROTEINS AND MORPHINE HAVE DEMONSTRATED ACTIVATION OF INFLAMMATORY SIGNALING IN THE HOST SYSTEM. HEREIN, WE SUMMARIZED THE CURRENT KNOWLEDGE ON THE ROLE OF OPIOIDS ON PERIPHERAL IMMUNOPATHOGENESIS, VIRAL IMMUNOPATHOGENESIS, EPIGENETIC PROFILES OF THE HOST AND VIRAL GENOME, NEUROPATHOGENESIS OF SIV/SHIV-INFECTED NON-HUMAN PRIMATES, BLOOD-BRAIN-BARRIER, HIV-1 VIRAL LATENCY, AND VIRAL REBOUND. OVERALL, THIS REVIEW PROVIDES RECENT INSIGHTS INTO THE ROLE OF OPIOIDS IN HIV-1 IMMUNOPATHOGENESIS. GRAPHICAL ABSTRACT. 2020 17 6706 28 VIRAL GENE PRODUCTS ACTIVELY PROMOTE LATENT INFECTION BY EPIGENETIC SILENCING MECHANISMS. MANY VIRUSES UNDERGO AN ACUTE INFECTION IN THE HOST ORGANISM AND THEN ARE CLEARED BY THE ENSUING HOST IMMUNE RESPONSE, BUT OTHER VIRUSES ESTABLISH A PERSISTENT INFECTION INVOLVING A LATENT INFECTION OR A CHRONIC INFECTION. LATENT INFECTION BY THE HERPESVIRUSES OR HUMAN IMMUNODEFICIENCY VIRUS INVOLVES EPIGENETIC SILENCING OF THE DNA GENOME OR PROVIRAL GENOME, RESPECTIVELY. LATENT INFECTION WAS PREVIOUSLY THOUGHT TO BE A DEFAULT PATHWAY RESULTING FROM INFECTION OF A NONPERMISSIVE CELL, BUT RECENT STUDIES HAVE SHOWN THAT VIRAL GENE PRODUCTS CAN PROMOTE EPIGENETIC SILENCING AND LATENT INFECTION. THIS REVIEW WILL SUMMARIZE THE VIRAL GENE PRODUCTS THAT HAVE BEEN SHOWN TO PROMOTE EPIGENETIC SILENCING OF THE GENOMES AND THEIR POTENTIAL FOR THERAPEUTICS TO TARGET THESE VIRAL GENE PRODUCTS AND DISRUPT OR LOCK IN LATENT INFECTION. 2017 18 4241 38 METHYLATION REGULATION OF ANTIVIRAL HOST FACTORS, INTERFERON STIMULATED GENES (ISGS) AND T-CELL RESPONSES ASSOCIATED WITH NATURAL HIV CONTROL. GWAS, IMMUNE ANALYSES AND BIOMARKER SCREENINGS HAVE IDENTIFIED HOST FACTORS ASSOCIATED WITH IN VIVO HIV-1 CONTROL. HOWEVER, THERE IS A GAP IN THE KNOWLEDGE ABOUT THE MECHANISMS THAT REGULATE THE EXPRESSION OF SUCH HOST FACTORS. HERE, WE AIMED TO ASSESS DNA METHYLATION IMPACT ON HOST GENOME IN NATURAL HIV-1 CONTROL. TO THIS END, WHOLE DNA METHYLOME IN 70 UNTREATED HIV-1 INFECTED INDIVIDUALS WITH EITHER HIGH (>50,000 HIV-1-RNA COPIES/ML, N = 29) OR LOW (<10,000 HIV-1-RNA COPIES/ML, N = 41) PLASMA VIRAL LOAD (PVL) LEVELS WERE COMPARED AND IDENTIFIED 2,649 DIFFERENTIALLY METHYLATED POSITIONS (DMPS). OF THESE, A CLASSIFICATION RANDOM FOREST MODEL SELECTED 55 DMPS THAT CORRELATED WITH VIROLOGIC (PVL AND PROVIRAL LEVELS) AND HIV-1 SPECIFIC ADAPTIVE IMMUNITY PARAMETERS (IFNG-T CELL RESPONSES AND NEUTRALIZING ANTIBODIES CAPACITY). THEN, CLUSTER AND FUNCTIONAL ANALYSES IDENTIFIED TWO DMP CLUSTERS: CLUSTER 1 CONTAINED HYPO-METHYLATED GENES INVOLVED IN ANTIVIRAL AND INTERFERON RESPONSE (E.G. PARP9, MX1, AND USP18) IN INDIVIDUALS WITH HIGH VIRAL LOADS WHILE IN CLUSTER 2, GENES RELATED TO T FOLLICULAR HELPER CELL (TFH) COMMITMENT (E.G. CXCR5 AND TCF7) WERE HYPER-METHYLATED IN THE SAME GROUP OF INDIVIDUALS WITH UNCONTROLLED INFECTION. FOR SELECTED GENES, MRNA LEVELS NEGATIVELY CORRELATED WITH DNA METHYLATION, CONFIRMING AN EPIGENETIC REGULATION OF GENE EXPRESSION. FURTHER, THESE GENE EXPRESSION SIGNATURES WERE ALSO CONFIRMED IN EARLY AND CHRONIC STAGES OF INFECTION, INCLUDING UNTREATED, CART TREATED AND ELITE CONTROLLERS HIV-1 INFECTED INDIVIDUALS (N = 37). THESE DATA PROVIDE THE FIRST EVIDENCE THAT HOST GENES CRITICALLY INVOLVED IN IMMUNE CONTROL OF THE VIRUS ARE UNDER METHYLATION REGULATION IN HIV-1 INFECTION. THESE INSIGHTS MAY OFFER NEW OPPORTUNITIES TO IDENTIFY NOVEL MECHANISMS OF IN VIVO VIRUS CONTROL AND MAY PROVE CRUCIAL FOR THE DEVELOPMENT OF FUTURE THERAPEUTIC INTERVENTIONS AIMED AT HIV-1 CURE. 2020 19 3379 32 HIV LATENCY AND THE NONCODING RNA THERAPEUTIC LANDSCAPE. THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) BELONGS TO THE SUBFAMILY OF LENTIVIRUSES THAT ARE CHARACTERIZED BY LONG INCUBATION PERIODS AND CHRONIC, PERSISTENT INFECTION. THE VIRUS INTEGRATES INTO THE GENOME OF INFECTED CD4+ CELLS AND, IN A SUBPOPULATION OF CELLS, ADOPTS A TRANSCRIPTIONALLY SILENT STATE, A PROCESS REFERRED TO A VIRAL LATENCY. THIS PROPERTY MAKES IT EXCEEDINGLY DIFFICULT TO THERAPEUTICALLY TARGET THE VIRUS AND ERADICATE INFECTION. IF LEFT UNTREATED, THE INEXORABLE DEMISE OF THE INFECTED INDIVIDUAL'S IMMUNE SYSTEM ENSUES, A CAUSAL RESULT OF ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS). LATENTLY INFECTED CELLS PROVIDE A RESERVOIR THAT MAINTAINS VIRAL INFECTION INDEFINITELY. IN THIS CHAPTER WE EXPLORE THE ROLE OF NONCODING RNAS IN HIV INFECTION AND IN THE ESTABLISHMENT AND MAINTENANCE OF VIRAL LATENCY. BOTH SHORT AND LONG NONCODING RNAS ARE ENDOGENOUS MODULATORS OF EPIGENETIC REGULATION IN HUMAN CELLS AND PLAY AN ACTIVE ROLE IN GENE EXPRESSION. LASTLY, WE EXPLORE THERAPEUTIC MODALITIES BASED ON EXPRESSED RNAS THAT ARE CAPABLE OF COUNTERING INFECTION, TRANSCRIPTIONALLY REGULATING THE VIRUS, AND SUPPRESSING OR ACTIVATING THE LATENT STATE. 2015 20 3806 37 INTRACELLULAR INTERFERON SIGNALLING PATHWAYS AS POTENTIAL REGULATORS OF COVALENTLY CLOSED CIRCULAR DNA IN THE TREATMENT OF CHRONIC HEPATITIS B. INFECTION WITH THE HEPATITIS B VIRUS (HBV) IS STILL A MAJOR GLOBAL HEALTH THREAT AS 250 MILLION PEOPLE WORLDWIDE CONTINUE TO BE CHRONICALLY INFECTED WITH THE VIRUS. WHILE PATIENTS MAY BE TREATED WITH NUCLEOSIDE/NUCLEOTIDE ANALOGUES, THIS ONLY SUPPRESSES HBV TITRE TO SUB-DETECTION LEVELS WITHOUT ELIMINATING THE PERSISTENT HBV COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) GENOME. AS A RESULT, HBV INFECTION CANNOT BE CURED, AND THE VIRUS REACTIVATES WHEN CONDITIONS ARE FAVORABLE. INTERFERONS (IFNS) ARE CYTOKINES KNOWN TO INDUCE POWERFUL ANTIVIRAL MECHANISMS THAT CLEAR VIRUSES FROM INFECTED CELLS. THEY HAVE BEEN SHOWN TO INDUCE CCCDNA CLEARANCE, BUT THEIR USE IN THE TREATMENT OF HBV INFECTION IS LIMITED AS HBV-TARGETING IMMUNE CELLS ARE EXHAUSTED AND HBV HAS EVOLVED MULTIPLE MECHANISMS TO EVADE AND SUPPRESS IFN SIGNALLING. THUS, TO FULLY UTILIZE IFN-MEDIATED INTRACELLULAR MECHANISMS TO EFFECTIVELY ELIMINATE HBV, INSTEAD OF DIRECT IFN ADMINISTRATION, NOVEL STRATEGIES TO SUSTAIN IFN-MEDIATED ANTI-CCCDNA AND ANTIVIRAL MECHANISMS NEED TO BE DEVELOPED. THIS REVIEW WILL CONSOLIDATE WHAT IS KNOWN ABOUT HOW IFNS ACT TO ACHIEVE ITS INTRACELLULAR ANTIVIRAL EFFECTS AND HIGHLIGHT THE CRITICAL INTERFERON-STIMULATED GENE TARGETS AND EFFECTOR MECHANISMS WITH POTENT ANTI-CCCDNA FUNCTIONS. THESE INCLUDE CCCDNA DEGRADATION BY APOBECS AND CCCDNA SILENCING AND TRANSCRIPTION REPRESSION BY EPIGENETIC MODIFICATIONS. IN ADDITION, THE MECHANISMS THAT HBV EMPLOYS TO DISRUPT IFN SIGNALLING WILL BE DISCUSSED. DRUGS THAT HAVE BEEN DEVELOPED OR ARE IN THE PIPELINE FOR COMPONENTS OF THE IFN SIGNALLING PATHWAY AND HBV TARGETS THAT DETRACT IFN SIGNALLING MECHANISMS WILL ALSO BE IDENTIFIED AND DISCUSSED FOR UTILITY IN THE TREATMENT OF HBV INFECTIONS. TOGETHER, THESE WILL PROVIDE USEFUL INSIGHTS INTO DESIGN STRATEGIES THAT SPECIFICALLY TARGET CCCDNA FOR THE ERADICATION OF HBV. 2021