Keeping Up With Advances in Hepatitis C Treatment

A new review published in F1000Research summarizes the tremendous progress made in the last decade to understand the biology of hepatitis C virus (HCV). The article also discusses major challenges that remain and the implications of recent and future research.

New capabilities to characterize viral replication recently led to the emergence of antiviral therapies that are changing the clinical landscape for the treatment of HCV in developed countries. Today, novel direct-acting antiviral agents (DAAs) are used as a common regimen to manage and even cure HCV infection.

Authors note, however, that a number of big research challenges remain to significantly decrease the spread of HCV on a global scale. Approximately 130 to 150 million people remain chronically infected with HCV worldwide, without easy access to treatment.

Current DAAs are not accessible widely because of their high cost. Also, DAAs are limited by (1) a low barrier to resistance-associated mutations; and (2) an inability to treat challenging patient groups, HCV-induced liver disease, and hepatocellular carcinoma (HCC).

Authors argue that these limitations underscore the need for continued research to develop more cost-effective DAAs and a HCV vaccine that can significantly reduce the disease on a global scale.

Implications of Hepatitis C Research

Authors pointed out that advances in understanding the HCV life cycle are important beyond the scope of HCV therapies or a potential HCV vaccine. New insights into HCV biology also are extremely valuable and useful to understand the biology of related viruses like dengue virus, which is becoming a serious global health concern. Discoveries potentially could lead to controlling or even eradicating viral epidemics on a global scale.

Recent Advances in Hepatitis C Research

Major advances in the knowledge of HCV biology and pathogenesis, over the past few years, are discussed in detail in this report, including:

• Discovery of the envelope glycoprotein E2 core structure.
• Generation of the first mouse model with inheritable susceptibility to HCV.
• Characterization of virus—host interactions that regulate viral replication or innate immunity.

New Directions for Hepatitis C Research

The current status and future direction of HCV research are explained in detail by the authors. Highlights include:

• Continuing research into the viral entry dynamics of HCV and its fusion mechanism to understand how it is spread from one host to another.
• Gaining better understanding of critical immunological events regulating outcome of infection, to potentially evaluate vaccine candidates. For example, why is acute HCV infection spontaneously cured in 20% to 30% of patients?
• Developing strategies to increase the resistance barrier of DAAs.
• Understanding HCV-induced mechanisms leading to liver disease and cancer.
• Gaining insights into E1E2 structures and conformational changes to develop an effective HCV vaccine.