The determinants of the maintenance of chronic hepadnaviral infection are yet to be fully understood. A long-standing unresolved argument in the hepatitis B virus (HBV) research field suggests that during chronic hepadnaviral infection, cell-to-cell spread of hepadnavirus is at least very inefficient (if it occurs at all), virus superinfection is an unlikely event, and chronic hepadnavirus infection can be maintained exclusively via division of infected hepatocytes in the absence of virus spread. Superinfection exclusion was previously shown for duck HBV, but it was not demonstrated for HBV or HBV-related woodchuck hepatitis virus (WHV). Three woodchucks, which were chronically infected with the strain WHV7 and already developed WHV-induced hepatocellular carcinomas (HCCs), were superinfected with another WHV strain, WHVNY. Six weeks after the superinfection, the woodchucks were sacrificed and tissues of the livers and HCCs were examined. The WHVNY superinfection was demonstrated by using WHV strain-specific PCR assays and (
Worldwide, approximately four hundred million people are chronic carriers of human hepatitis B virus (HBV), which is a prototype hepadnavirus. Chronic HBV infection is a main risk factor of hepatocellular carcinoma (HCC), and it is associated with more than 50% of all known cases of HCC (1-14). During the early stage of hepadnaviral infection, virtually the entire liver becomes infected with a hepadnavirus within several weeks. However, during chronic infection, areas of apparently hepadnavirusfree hepatocytes were observed in HBV carrier humans and chimpanzees and also in woodchucks chronically infected with woodchuck hepatitis virus (WHV), which is closely related to HBV. The hepadnavirus-free hepatocytes tested negative for (i) the hepadnavirus core antigen (by immunostaining) and (ii) the viral DNA (by in situ hybridization) regardless of the ongoing viremia. In HBV carrier humans, up to 90% of all hepatocytes could appear to be HBV free. Some of the virus-free hepatocytes form foci of altered hepatocytes (FAH) with morphology similar to that of liver cancer cells and are considered premalignant. In addition, the cells of hepadnavirus-induced HCCs often were reported to be virus free as well (1,4,(15)(16)(17)(18)(19)(20)(21)(22)(23). In contrast, several previous studies reported the presence of hepadnaviral , making the issue still controversial. The observations of apparent hepadnavirus-free HCC cells and hepatocytes, along with the analysis of the kinetics of the emergence of drug-resistant HBV mutants, laid the foundation for a long-standing unresolved argument in the HBV field that during chronic infection, cell-to-cell spread of a hepadnavirus is at least very inefficient (if it occurs at all), and superinfection is an un-