Key result
Azathioprine reduces HAV replication by ~44% in human hepatocyte cultures without cytotoxicity.
Why the study?
Breakthrough hepatitis A virus infections can occur in immunocompromised populations, but the effect of immunosuppressants on HAV replication is unclear.
Does azathioprine inhibit Hepatitis A virus replication in vitro?
Does azathioprine inhibit Hepatitis A virus replication in vitro?
Azathioprine inhibits Hepatitis A virus replication and translation in vitro, suggesting potential utility in HAV-infected patients requiring immunosuppression.
Answers are grounded in this paper and cite their sources.
May support azathioprine in HAV patients needing immunosuppression; leaves open antiviral repurposing pending clinical validation.
Hepatitis A virus (HAV) infection can occasionally cause acute severe hepatitis. Patients with this disease sometimes need to undergo liver transplantation with immunosuppressants. Although rare, breakthrough HAV infections, despite vaccination, appear to be more common among immunocompromised populations. The effect of immunosuppressants on HAV replication is unclear. In this study, we examined the effects of immunosuppressants on HAV HA11-1299 genotype IIIA replication in human hepatocytes, finding that azathioprine inhibited HAV replication with a half-maximal inhibitory concentration of 0.967 μmol/L. We further examined the effect of azathioprine on the replication of HAV HM175 18f genotype IB using replication-competent or replication-incompetent subgenomic replicon in HuhT7 cells. Azathioprine had significant inhibitory effects on the HAV replication-competent subgenomic replicon compared to the replication-incompetent subgenomic replicon. The effect of azathioprine on the activity of the HAV HM175 18f genotype IB-internal ribosomal entry site (IRES) was investigated in COS7-HAV-IRES cells using a reporter assay. Azathioprine at 1 μmol/L had a significant inhibitory effect on HAV IRES activity but at 0.5 μmol/L had no inhibitory effect. Azathioprine appears to inhibit HAV replication as well as HAV translation. In conclusion, we found that azathioprine inhibits HAV replication in human hepatocytes, meaning that it may be useful for patients with a HAV infection who need to use immunosuppressants.
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Kanda et al. (2026) studied Human hepatocytes infected with Hepatitis A virus HA11-1299 genotype IIIA or HM175/18f genotype IB in vitro cell models. Azathioprine vs. No treatment (untreated control) was evaluated on Inhibition of Hepatitis A virus (HAV) replication measured by HAV RNA quantification or luciferase reporter assay (IC50 0.967 µmol/L, p=<0.05). Azathioprine inhibited Hepatitis A virus replication with an IC50 of 0.967 µmol/L and reduced HAV subgenomic replicon activity to 56.2% of control without cytotoxicity in human hepatocyte cultures.
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