Hepatitis C virus (HCV) isApproximately 170 million individuals worldwide suffer from chronic hepatitis C virus (HCV) infection (38). Although the acute phase of infection is usually associated with mild symptoms, most patients acquire a persistent infection that frequently leads to chronic liver diseases, including cirrhosis and hepatocellular carcinoma (21,25). At present, alpha interferon (IFN-␣) in combination with ribavirin or a polyethylene glycolmodified form of IFN-␣ in combination with ribavirin is the only recommended therapy. IFN-based therapies have shown only limited efficacy and are unsuitable for certain patient populations, although IFN-based therapies are relatively more efficacious against genotypes 2 and 3 than against genotype 1 (13,30,31,34). The limited efficacy against genotype 1 and the poor tolerability of IFN-based therapies warrant the search for more effective medicines to combat HCV infection.HCV is the only member of the genus Hepacivirus that belongs to the family Flaviviridae. HCV contains a single-stranded, positive-sense RNA genome of approximately 9.5 kb which encodes a unique polyprotein (10). The polyprotein precursor is co-and posttranslationally processed by cellular and viral proteases to yield the mature structural and nonstructural proteins, arranged in the sequence NH 2 -C-E1-E2-P7-NS2-NS3-NS4A-NS4B-NS5A-NS5B-COOH. The inability to efficiently propagate HCV in cell culture has impeded the development of drugs against this virus. This obstacle was overcome, to a degree, by the recent development of a bicistronic subgenomic HCV replicon in Huh-7 cells (5, 26). These subgenomic replicon systems have greatly facilitated studies of HCV replication.The pharmaceutical industry has also been using such replication systems to screen for anti-HCV drugs (2).A reporter gene that can be used to monitor HCV RNA replication by simply measuring the enzymatic activity of secreted alkaline phosphatase (SEAP) in the culture medium has been developed previously (23). In this study, we focused on screening a set of marketed drugs, including drugs not approved for antiviral indications. Here, we report on the discovery that As 2 O 3 is a potent anti-HCV agent. We also showed that As 2 O 3 and IFN-␣ have synergistic antiviral effects when they are used together. Recently, the U.S. Food and Drug Administration approved As 2 O 3 for use for the treatment of acute promyelocytic leukemia (APL) (8, 37). The possibility that As 2 O 3 or its analogues may be used for the treatment of HCV infections is discussed.
MATERIALS AND METHODSCompound collection. The compounds tested were mainly from The Genesis Plus Collection (MicroSource Discovery Systems, Inc., Gaylordsville, Conn.). The 960 compounds in this library are primarily U.S. Food and Drug Administration-approved compounds. An alphabetical list of the compounds can be found at the MicroSource Discovery Systems website (http://www.msdiscovery .com/genplus3.html). In addition, several other drugs used for the treatment of HCV infections, including...