Treatment failure in hepatitis C: mechanisms of non-response.
Hepatitis C virus (HCV) has evolved remarkable mechanisms that favor viral persistence by interfering with host innate and adaptive immune responses. These same mechanisms are likely to contribute to resistance to exogenously administered interferon used for HCV treatment. We review the host innate and adaptive immune responses in the context of HCV infection as well as the strategies by which these responses are subverted by the virus. In addition, the contribution of host factors, such as race and insulin resistance, to interferon non-responsiveness is discussed. Our progress in understanding the molecular underpinnings of interferon treatment failure in HCV infection has resulted in several promising and novel treatment strategies for HCV treatment non-responders.
Tai
Andrew W
AW
Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, WRN 1007, 55 Fruit Street, Boston, MA 02114, USA.
Chung
Raymond T
RT
D024882:Drug Resistance, Viral; D006526:Hepatitis C / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D007370:Interferon Type I / Q000502:physiology; D007372:Interferons / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D017211:Treatment Failure; D014762:Viral Interference
D007370:Interferon Type I; D012254:Ribavirin; D007372:Interferons