State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
Infect Genet Evol. 2014 Mar;22:120-9. doi: 10.1016/j.meegid.2014.01.008. Epub 2014 Jan 23.
Hepatitis C virus (HCV) is a blood-borne pathogen which has chronically infected about 130-210 million people worldwide. Current standard-of-care (SoC) therapy is an inadequate and expensive treatment with more side effects. Two direct-acting antiviral agents (DAAs) (telaprevir and boceprevir) in combination with SoC therapy have been used in patients infected with HCV genotype 1. Although these drugs result in a shortening of therapy, they also have additional side effects and are expensive. In their stead, several second-generation DAAs are being investigated. What important is that all-oral, interferon (IFN)- and ribavirin-free regimens for the treatment of HCV-infected patients are now being investigated, and will be applied in the next year. Preventive measures against HCV, including vaccine development, are also now in progress. However, no therapeutic vaccine against HCV has been produced to date. An effective vaccine should induce robust and broadly cross-reactive CD4(+), CD8(+)T-cell and neutralising antibody (NAb) responses. Current data indicate that vaccines can usually not completely prevent HCV infection but rather prevent the progression of HCV infection to chronic and persistent infection, which may be a realistic goal. This review discusses the important roles of NAbs and CD8(+)T-cells in the development of therapeutic vaccines, and summarizes some important epitopes of HCV recognized by CD8(+)T-cells and some prospective therapeutic vaccine approaches.
丙型肝炎病毒（HCV）是一种血源性病原体，已在全球范围内慢性感染了约 1.3 亿至 2.1 亿人。目前的标准治疗（SoC）是一种不充分且昂贵的治疗方法，副作用更多。两种直接作用的抗病毒药物（DAAs）（特拉匹韦和博赛匹韦）与 SoC 联合治疗已用于感染 HCV 基因型 1 的患者。尽管这些药物缩短了治疗时间，但它们也有额外的副作用，而且价格昂贵。取而代之的是，正在研究几种第二代 DAAs。重要的是，目前正在研究用于治疗 HCV 感染患者的无干扰素（IFN）和利巴韦林的全口服、无干扰素（IFN）和利巴韦林的治疗方案，并且将在明年应用。针对 HCV 的预防措施，包括疫苗的开发，也在进行中。然而，到目前为止，还没有针对 HCV 的治疗性疫苗。有效的疫苗应该诱导强大且广泛交叉反应的 CD4(+)、CD8(+)T 细胞和中和抗体（NAb）反应。目前的数据表明，疫苗通常不能完全预防 HCV 感染，而是预防 HCV 感染向慢性和持续性感染的进展，这可能是一个现实的目标。这篇综述讨论了 NAb 和 CD8(+)T 细胞在治疗性疫苗开发中的重要作用，并总结了一些 HCV 被 CD8(+)T 细胞识别的重要表位和一些有前途的治疗性疫苗方法。
