Evidence map›Paper›PMID 41856207›Full record

ReviewAntiviral research2026

Hepatitis B virus ribonuclease H inhibitors: Coming of age?

Holly M Walden, Helena Tsimpili, Molly E Woodson, Grigoris Zoidis, John E Tavis

Abstract readReview
In one paragraph

Review in Antiviral research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Holly M WaldenDepartment of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA; Institute for Drug and Biotherapeutic Innovation, Saint Louis University, Saint Louis, MO, USA.
Helena TsimpiliDepartment of Pharmacy, Division of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Molly E WoodsonDepartment of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA; Institute for Drug and Biotherapeutic Innovation, Saint Louis University, Saint Louis, MO, USA. Electronic address: Molly.Woodson@discovery.eurofinsus.com.
Grigoris ZoidisDepartment of Pharmacy, Division of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
John E TavisDepartment of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA; Institute for Drug and Biotherapeutic Innovation, Saint Louis University, Saint Louis, MO, USA. Electronic address: John.tavis@health.slu.edu.

Funding

Lead optimization of Hepatitis B Virus ribonuclease H inhibitorsR01AI150610 · NIAID · SAINT LOUIS UNIVERSITY · PI MEYERS, MARVIN J, TAVIS, JOHN E · 2021 to 2025
$3.3M
NIAID NIH HHS R01 AI150610
6 · The paper itself

Abstract

Hepatitis B virus (HBV) replicates by reverse transcription in hepatocytes. It chronically infects >250 million people worldwide and kills ∼1.1 million annually. Current therapies for chronic HBV rely on nucleos(t)ide analogs as the front-line treatment or with pegylated interferon α. Neither type of therapy is curative, nucleos(t)ide analog therapy is usually life-long, and interferon α treatment causes substantial side effects. Therefore, novel therapies for HBV are urgently needed. The HBV ribonuclease H (RNase H) is one of the two viral enzymes needed for HBV reverse transcription, and it is not targeted by the existing HBV drugs. We have explored four chemotypes as HBV RNase H inhibitors, N-hydroxyisoquinolinediones (HID), α-hydroxytroplones (αHT), N-hydroxynapthyridinones (HNO), and N-hydroxypyridinediones (HPD). The HIDs and αHTs were terminated due to inability to improve efficacy and in vitro pharmacological liabilities, the HNOs have been de-emphasized due to limited efficacy, but the HPDs are under active development. The best HPDs have low nanomolar efficacies against HBV replication, selectivity indexes in culture of >1,000, and are synergistic with nucleos(t)ide analogs. Proof-of-principle in vivo efficacy has been demonstrated for an early HPD molecule, and the best HPDs are entering mouse efficacy, pharmacology, and toxicity studies. Here, we review the synthetic chemistry, efficacy, cytotoxicity, mechanism of action, effects on viral replication, and in vitro pharmacology of the HBV RNase H inhibitors. The goal is to develop drugs targeting the RNase H that could be used in combination with other drugs to achieve functional cures in people living the chronic HBV.

Indexed as

Antiviral AgentsEnzyme InhibitorsHepatitis B virusRibonuclease HAnimalsHumansVirus ReplicationAntiviral AgentsEnzyme InhibitorsRibonuclease HDrug discoveryHepatitis B virusN-hydroxypyridinedionesRibonuclease HSynergyα-hydroxytropolones

Identifiers

PMID41856207
PMCPMC13224728

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.