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Semin Liver Dis 2014; 34(01): 079-088
DOI: 10.1055/s-0034-1371081
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Will There Be a Vaccine to Prevent HCV Infection?

Jonathan R. Honegger
1   The Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, Ohio
2   Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
,
Yan Zhou
1   The Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, Ohio
,
Christopher M. Walker
1   The Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, Ohio
2   Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
› Author Affiliations
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Publication History

Publication Date:
29 April 2014 (online)

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Abstract

Prevention of hepatitis C virus (HCV) infection by vaccination has been a priority since discovery of the virus and the need has not diminished over the past 25 years. Infection rates are increasing in developed countries because of intravenous drug use. Reducing transmission will be difficult without a vaccine to prevent persistence of primary infections, and also secondary infections that may occur after cure of chronic hepatitis C with increasingly effective direct-acting antiviral (DAA) regimens. Vaccine need is also acute in resource poor countries where most new infections occur and DAAs may be unaffordable. Spontaneous resolution of HCV infection confers durable protection, but mechanisms of immunity remain obscure and contested in the context of vaccine design. A vaccine must elicit a CD4+ helper T cell response that does not fail during acute infection. The need for neutralizing antibodies versus cytotoxic CD8+ T cells is unsettled and reflected in the design of two very different vaccines evaluated in humans for safety and immunogenicity. Here we review the status of vaccine development and the scientific and practical challenges that must be met if the burden of liver disease caused by HCV is to be reduced or eliminated.

Keywords

hepatitis C virus - vaccine - direct acting antiviral - persistent infection