Toward a vaccine against hepatitis C virus

摘要

Avaccine protecting against chronic infection with hepatitis C virus (HCV) is urgently needed to address the ongoing public health crisis caused by this insidious pathogen-a major cause of liver cirrhosis and cancer. Efforts toward development of vaccines were initiated after the discovery of HCV in 1989, but to date, no vaccine has been licensed. An increased understanding of HCV protective immunity and HCV envelope glycoprotein structure and function is paving the way toward rational vaccine design and evaluation. HCV is mainly transmitted through blood, but sexual and perinatal transmissions do occur. Worldwide, most transmissions are caused by unsafe medical procedures, but ～20% occur in people who inject drugs (PWID), an important risk group in high-income countries; another risk group in high-income countries is men who have sex with men (2). The World Health Organization (WHO) estimates that 1.5 million new infections occur annually, and incidence is increasing in many countries, including the US, where transmission is fueled by the opi-oid crisis. About 75% of infections progress to chronic hepatitis C, estimated to affect 58 million individuals worldwide. Chronic hepatitis C leads to liver cirrhosis in ~20% of cases, which also comes with an -5% annual risk for the development of hepatocellular carcinoma Annually, HCV-induced liver diseases cause ～290,000 deaths worldwide.