Current status of a hepatitis C vaccine: encouraging results but significant challenges ahead.
Persistent hepatitis C virus (HCV) infection affects 170 million people worldwide. Acute HCV infection is often asymptomatic, but many infected individuals develop persistent infections that may lead to development of end-stage liver diseases, including liver cirrhosis and hepatocellular carcinoma. Thus, an HCV vaccine that could significantly lower the chronicity rate would have a major impact on the disease burden. Unfortunately, HCV is a highly mutable virus, and escape mutations can undermine vaccine-induced virus-specific immunity. Also, HCV exists as multiple genotypes, and so genotype-specific vaccines might be required to achieve broad protection. Finally, vaccine development has been hampered by the lack of a small animal model and cell culture systems, but these are currently being established. Despite these obstacles, several vaccine candidates tested in the chimpanzee HCV model have shown some encouraging results.
Mikkelsen
Marianne
M
Department of International Health, Immunology, and Microbiology, University of Copenhagen, The Panum Institute, Building 24.2, Blegdamsvej 3c, DK-2200 Copenhagen N, Denmark.
Bukh
Jens
J