Viral hepatitis update: Progress and perspectives

Table 4 Hepatitis C virus highlights

	Hepatitis C virus
1	WHO global hepatitis elimination strategy aims to reduce 90% of new HCV incidence, 65% of mortality and treat at least 80% of patients
2	DAA treatment leads to regression of clinical symptoms and liver disease complications even in those patients with other comorbidities, co-infections, or advanced liver disease
3	The immune response plays a central role in viral elimination. The understanding of the relationship between achieving protection and activation of immune responses is mandatory for the development of an effective prophylactic vaccine
4	Immune response restoration after DAA treatment is also under debate, certain immune features are reinvigorated, but many immune exhaustion signs may persist
5	SVR after DAA rates higher than 97% are usually attained, but still, a minor group of patients (4%-5%) fails to eradicate HCV due to resistance-associated variants, some of them arising after treatment but others naturally occurring in treatment naïve individuals
6	DAA efficacy impacts on transplantation from HCV-infected donors into infected or uninfected recipients; however, early outcome data are encouraging, experience is limited, and many issues remain under debate
7	HCC risk after DAA treatment has been extensively discussed; however, recent seminal reports support the notion of a reduced rate for occurrence or recurrence of HCC after DAA SVR
9	There are numerous HCV vaccine approaches including a few candidates who accomplished phase I trials, but a prophylactic HCV vaccine that can contribute to the eradication goal remains a pending issue

DAA: Direct antiviral agents; SVR: Sustained virological response; WHO: World Health Organization; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma.