Critical challenges and emerging opportunities in hepatitis C virus research in an era of potent antiviral therapy: Considerations for scientists and funding agencies

• Published in: Virus research Vol. 248; pp. 53 - 62
• Main Authors: Bartenschlager, Ralf, Baumert, Thomas F., Bukh, Jens, Houghton, Michael, Lemon, Stanley M., Lindenbach, Brett D., Lohmann, Volker, Moradpour, Darius, Pietschmann, Thomas, Rice, Charles M., Thimme, Robert, Wakita, Takaji
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.03.2018
• Subjects: antiviral agents; cell biology; chronic hepatitis C; Direct acting antiviral therapy; genotype; HCV research funding; HCV vaccine; Hepatitis C virus; Human health and pathology; Immune reconstitution; Life Sciences; liver transplant; neoplasms; patients; research support; risk; scientists; sterilizing immunity; vaccines; viruses; Immune reconstitution; HCV vaccine; Direct acting antiviral therapy; HCV research funding
• ISSN: 0168-1702; 1872-7492; 1872-7492
• DOI: 10.1016/j.virusres.2018.02.016

•New direct-acting antivirals (DAAs) eliminate persistent hepatitis C virus infection in >95% of patients.•DAAs are so successful, some question the need for continued research.•Critical public health, translational and clinical challenges remain.•A vaccine that prevents chronic infection is essential for global HCV eradication.•A unique research “toolbox” offers opportunities that warrant sustained funding. The development and clinical implementation of direct-acting antivirals (DAAs) has revolutionized the treatment of chronic hepatitis C. Infection with any hepatitis C virus (HCV) genotype can now be eliminated in more than 95% of patients with short courses of all-oral, well-tolerated drugs, even in those with advanced liver disease and liver transplant recipients. DAAs have proven so successful that some now consider HCV amenable to eradication, and continued research on the virus of little remaining medical relevance. However, given 400,000 HCV-related deaths annually important challenges remain, including identifying those who are infected, providing access to treatment and reducing its costs. Moreover, HCV infection rarely induces sterilizing immunity, and those who have been cured with DAAs remain at risk for reinfection. Thus, it is very unlikely that global eradication and elimination of the cancer risk associated with HCV infection can be achieved without a vaccine, yet research in that direction receives little attention. Further, over the past two decades HCV research has spearheaded numerous fundamental discoveries in the fields of molecular and cell biology, immunology and microbiology. It will continue to do so, given the unique opportunities afforded by the reagents and knowledge base that have been generated in the development and clinical application of DAAs. Considering these critical challenges and new opportunities, we conclude that funding for HCV research must be sustained.