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丙型肝炎疫苗。当下的需求。

Hepatitis C vaccine. Need of the hour.

作者信息

Verma Ramesh, Khanna Pardeep, Chawla Suraj

机构信息

a Department of Community Medicine; Pt. B.D. Sharma PGIMS; Rohtak, Haryana India.

出版信息

Hum Vaccin Immunother. 2014;10(7):1927-9. doi: 10.4161/hv.29033.

Abstract

Hepatitis C virus (HCV) was first identified in 1989. HCV is a small, enveloped RNA virus. Globally, 3-4 million persons are infected with HCV each year, and are at risk of developing liver cirrhosis and/or liver cancer. The common modalities of the spread of hepatitis C infection are blood transfusions, injection drug use, unsafe therapeutic injections, and healthcare-related procedures. The standard treatment for hepatitis C has been combination antiviral therapy with interferon (IFN) and ribavirin, which are effective against all the genotypes of hepatitis viruses (pan-genotypic). A 12-month course of Peg-IFN/ribavirin treatment costs > $20 000. New HCV-specific antiviral drugs, especially in combination, have shown very high cure rates; however, the annual cost for a single subject ($82 000) make these unaffordable in most of the world. There is no hepatitis C vaccine. However, several vaccines in development, and some have shown promising preclinical results. Over the last few years, numerous HCV vaccine approaches have been assessed in mice and primates, but only a few vaccines have progressed to human trials. The challenge to develop HCV vaccine is to move into larger at-risk or infected populations to test efficacy.

摘要

丙型肝炎病毒(HCV)于1989年首次被发现。HCV是一种小型包膜RNA病毒。全球每年有300万至400万人感染HCV,并有发展为肝硬化和/或肝癌的风险。丙型肝炎感染的常见传播方式是输血、注射吸毒、不安全的治疗性注射以及与医疗保健相关的操作。丙型肝炎的标准治疗方法一直是使用干扰素(IFN)和利巴韦林进行联合抗病毒治疗,这两种药物对所有基因型的肝炎病毒(泛基因型)均有效。聚乙二醇化干扰素/利巴韦林治疗12个月的疗程费用超过2万美元。新型HCV特异性抗病毒药物,尤其是联合使用时,已显示出非常高的治愈率;然而,单个人每年的费用(8.2万美元)使得世界上大多数地方都无法承受。目前尚无丙型肝炎疫苗。不过,有几种疫苗正在研发中,其中一些已显示出有前景的临床前结果。在过去几年中,许多HCV疫苗研发方法已在小鼠和灵长类动物身上进行了评估,但只有少数疫苗进入了人体试验阶段。开发HCV疫苗面临的挑战是扩大到更大规模的高危或感染人群中去测试疗效。

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