Zeisel Mirjam B, Crouchet Emilie, Baumert Thomas F, Schuster Catherine
Inserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, 67000 Strasbourg, France.
Université de Strasbourg, 67000 Strasbourg, France.
Viruses. 2015 Nov 2;7(11):5659-85. doi: 10.3390/v7112898.
Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma (HCC) which are leading indications of liver transplantation (LT). To date, there is no vaccine to prevent HCV infection and LT is invariably followed by infection of the liver graft. Within the past years, direct-acting antivirals (DAAs) have had a major impact on the management of chronic hepatitis C, which has become a curable disease in the majority of DAA-treated patients. In contrast to DAAs that target viral proteins, host-targeting agents (HTAs) interfere with cellular factors involved in the viral life cycle. By acting through a complementary mechanism of action and by exhibiting a generally higher barrier to resistance, HTAs offer a prospective option to prevent and treat viral resistance. Indeed, given their complementary mechanism of action, HTAs and DAAs can act in a synergistic manner to reduce viral loads. This review summarizes the different classes of HTAs against HCV infection that are in preclinical or clinical development and highlights their potential to prevent HCV infection, e.g., following LT, and to tailor combination treatments to cure chronic HCV infection.
慢性丙型肝炎病毒(HCV)感染是肝硬化和肝细胞癌(HCC)的主要病因,而肝硬化和肝细胞癌是肝移植(LT)的主要指征。迄今为止,尚无预防HCV感染的疫苗,肝移植后肝脏移植物总会被感染。在过去几年中,直接抗病毒药物(DAA)对慢性丙型肝炎的治疗产生了重大影响,在大多数接受DAA治疗的患者中,慢性丙型肝炎已成为可治愈的疾病。与靶向病毒蛋白的DAA不同,宿主靶向药物(HTA)干扰病毒生命周期中涉及的细胞因子。通过互补的作用机制以及通常表现出更高的耐药屏障,HTA为预防和治疗病毒耐药性提供了一种前瞻性选择。事实上,鉴于其互补的作用机制,HTA和DAA可以协同作用以降低病毒载量。本综述总结了处于临床前或临床开发阶段的针对HCV感染的不同类别的HTA,并强调了它们在预防HCV感染(例如肝移植后)以及定制联合治疗方案以治愈慢性HCV感染方面的潜力。