Approaches, Progress, and Challenges to Hepatitis C Vaccine Development.

Approaches, Progress, and Challenges to Hepatitis C Vaccine Development.
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DOI:
10.1053/j.gastro.2018.08.060
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发表时间:
2019-01
期刊:
影响因子:
29.4
通讯作者:
Cox AL
Cox AL
中科院分区:
医学1区
文献类型:
--
作者:
Bailey JR;Barnes E;Cox AL

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丙型肝炎病毒(HCV)感染的风险因素各不相同,2015年全球估计有175万新发病例。世界卫生组织的目标是到2030年将新的HCV感染减少90%。HCV疫苗将预防传播,无论风险因素如何,并显着减少HCV相关疾病的全球负担。发展的障碍包括病毒多样性,测试疫苗的有限模型,以及我们对保护性免疫反应的不完全理解。尽管高效疫苗可以完全预防感染,但增加HCV清除率和预防慢性感染的免疫应答可能足以减轻疾病负担。佐剂包膜或核心蛋白和病毒载体的非结构抗原疫苗已在没有HCV感染风险的健康志愿者中进行了测试;编码非结构蛋白的病毒载体是在风险个体中进行测试的唯一疫苗策略。尽管面临发展挑战,但预防性疫苗对于全球控制HCV是必要的。
Risk factors for hepatitis C virus (HCV) infection vary, and there were an estimated 1.75 million new cases worldwide in 2015. The World Health Organization aims for a 90% reduction in new HCV infections by 2030. An HCV vaccine would prevent transmission, regardless of risk factors, and significantly reduce the global burden of HCV-associated disease. Barriers to development include virus diversity, limited models for testing vaccines, and our incomplete understanding of protective immune responses. Although highly effective vaccines could prevent infection altogether, immune responses that increase the rate of HCV clearance and prevent chronic infection may be sufficient to reduce disease burden. Adjuvant envelope or core protein and virus-vectored nonstructural antigen vaccines have been tested in healthy volunteers who are not at risk for HCV infection; viral vectors encoding nonstructural proteins are the only vaccine strategy to be tested in at-risk individuals. Despite development challenges, a prophylactic vaccine is necessary for global control of HCV.
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