ddOTs: A multiplexed quantitative ddPCR approach for resolving overlapping hepatitis B virus transcripts to decipher cccDNA-driven transcription.

Chronic hepatitis B virus infection persists as a global health crisis, driving life-threatening liver pathologies such as hepatocellular carcinoma. Central to HBV's resilience is the covalently closed circular DNA (cccDNA), a viral minichromosome that orchestrates viral transcription and sustains infection. Dissecting cccDNA-driven transcription remains a formidable challenge due to the dense overlap of viral open reading frames, which generates RNA transcripts with shared sequences, complicating precise quantification and hindering efforts to unravel HBV's transcriptional regulation. To address this bottleneck, we developed a multiplexed assay named ddPCR for Overlapping Transcripts (ddOTs) capable of simultaneously quantifying all major HBV RNA species, including splice variants, with unprecedented specificity and sensitivity. This method overcomes current limitations by leveraging the high-resolution power of ddPCR to deconvolute overlapping transcripts, enabling direct interrogation of individual promoter/enhancer activities and RNA stability. By offering a cost-effective, scalable solution for precise RNA profiling in rare biological samples, this breakthrough tool unlocks new avenues for exploring cccDNA biology and accelerating antiviral drug development.