Towards the control of hepatitis C

Abstract

The discovery and characterisation of the hepatitis C virus (HCV) genome using a bacteriophage expression screening approach in 1989, quickly led to the development of blood tests to protect the blood supply and to diagnose and facilitate management of HCV patients. The viral-encoded serine protease and replicase then became major drug targets that in combination with viral NS5a-targeting drugs, that were facilitated by the use of in vitro genome replicon systems, has now led to most HCV patients being curable after just short treatment regimens. Natural immunity has been demonstrated in multiply-exposed individuals along with the identification of cellular immune correlates of protection. A growing role for neutralising antibodies in protection has also been indicated following the ability to grow HCV and viral pseudoparticles in cell culture. This knowledge has led to the pre-clinical and clinical testing of various promising vaccine candidates. Approval of HCV vaccines along with the development of much cheaper antiviral drugs will eventually lead to the effective global control of this virus which currently infects an estimated 150 million carriers around the world.