HCV, a plus strand RNA virus has chronically infected ca. 71 mio individuals and a vaccine is not available. In fact, chronic HCV infection is associated with about 30% of liver cancers worldwide and among the leading indications for orthotopic liver transplantation. Another RNA virus is hepatitis E virus (HEV) which is responsible for epidemics and endemics of acute hepatitis mainly through waterborne, foodborne, and zoonotic transmission routes. The research group “Virus Transmission” of Prof. Eike Steinmann is working on molecular and clinical transmission pathways of hepatitis C virus (HCV) and hepatitis E virus (HEV) causing severe infections in humans. Therefore, new prevention strategies and therapies for these two RNA viruses should be developed. Risks of virus transmission in the environment, especially in the hospital should be identified as well as effective methods for virus inactivation established and validated. Another focus is to investigate the relevance and utility of HCV-related viruses in horses as model for HCV transmission and pathogenesis. The so-called non-primate hepacivirus (NPHV) is the closest relative of HCV described to date und opens new opportunities to study the natural infection of NPHV in its host.
Intervention strategies against HEV
Hepatitis E virus (HEV) can take chronic infections in immunocompromised patients leading to liver cirrhosis and liver failure. Ribavirin is currently the only treatment option for many patients, but treatment failure can occur, which has been associated with a mutation in the HEV polymerase. We aim to investigate HEV polymerase evolution prior to and during ribavirin therapy in patients with chronic hepatitis to understand the mode of action of the drug in vivo (Todt et al. Gut 2016). Furthermore, we could demonstrate for the first time in tissue culture that HEV replication is not restricted to the liver and can potentially complete the full viral life cycle in neuronal-derived tissues explaining neurological disorders during HEV infection (Drave et al. JVH 2016). As another goal, we plan together with partners from the Helmholtz Center for Infection Research to screen natural compounds against HEV replication to discover novel compounds for the treatment of HEV infections.
Transmission and prevention measures of HCV
The aim is to understand and explore ways of HCV transmission in the environment especially in healthcare settings and among injection drug users. In the past, we evaluated the environmental stability of HCV and its susceptibility to chemical biocides (Ciesek et al. JID 2010) and against novel disinfectant formulations proposed by the WHO (Steinmann et al. AJIC 2010, Steinmann et al. ARIC et al. 2013). Furthermore, we could show that HCV-contaminated medication like propofol or fentanyl can influence virus stability (Steinmann et al. CID 2011, Behrendt et al. AJIC 2013). More recently, we also studied cross-transmission among PWID’s by contamination of drug preparation equipment and survival of dried HCV on inanimate surfaces (Doerrbecker et al. JID 2011, Doerrbecker et al. JID 2013). Furthermore, we evaluated the influence of heroin of HCV and HIV-1 infectivity in a drug transmission assay and characterized the use of microwaves as prevention strategy for these blood-borne viruses (Siddharta et al. Sci Rep 2016).