We describe here a novel targeting gene therapy strategy to direct gene expression responsive to hepatitis C virus (HCV). The goal was approached by engineering a construct containing the antisense sequence of the transgene and internal ribosome entry site of encephalomyocarditis virus flanked by 5-and 3-end sequences of HCV cDNA that contain cis-acting replication elements. Thus, expression of the transgene is only promoted when the minus-strand RNA has been synthesized by the functional replication machinery present in infected cells. Reporter assay and strand-specific reverse transcription-PCR showed selective transgene expression in Huh-7 cells harboring an autonomously replicating HCV subgenome but remaining silent in uninfected cells. Furthermore, using the cytosine deaminase suicide gene as a transgene coupled with recombinant adenovirus delivery, we demonstrated that cytosine deaminase was specifically expressed in replicon cells, resulting in marked chemosensitization of replicon cells to the cytotoxic effects of flucytosine. This new targeting strategy could be extended to other single-stranded RNA viruses encoding the unique RNA-dependent RNA polymerase that has no parallel in mammalian cells.Chronic hepatitis C virus (HCV) infection, which frequently leads to liver cirrhosis and hepatocellular carcinoma (3, 34), remains a major public health problem worldwide. It has been estimated that more than 3% of the world population is infected with HCV. The plus-strand HCV RNA genome is approximately 9,600 nucleotides in length and encodes a polyprotein precursor of about 3,010 amino acids, which is cleaved co-and posttranslationally by cellular and viral proteases to produce structural and nonstructural (NS) proteins (8,13,15). One of the NS proteins, NS5B, is an RNA-dependent RNA polymerase (RdRp) that catalyzes the replication of HCV (5, 30).Current treatment modalities available for HCV infection, including alpha interferon, has limited effectiveness. Only 20 to 30% of alpha interferon-treated patients develop a sustained remission, and increased or prolonged systemic administration is often associated with severe side effects or viral resistance. The combination of ribavirin and interferon is known to be significantly more effective than interferon monotherapy in naïve and relapser patients, but it induces a sustained response only in 41% of patients and in less than 30% of patients infected with genotype 1 (18). The therapeutic potential of small inhibitory molecules that target serine protease, helicase, or RdRp has proved to be promising (4, 6, 10), however, one unavoidable problem of this approach is selection of resistant mutants conferred by single or multiple mutations due to the error-prone nature of RdRp (24,26,29). Thus, an alternative approach for treating HCV patients that results in the death of infected cells, thereby limiting or eliminating virus production, while leaving uninfected cells unharmed would have an advantage over the HCV therapies now available.Here we describe a targeting gen...