Published online Aug 7, 2014. doi: 10.3748/wjg.v20.i29.9633
Revised: April 20, 2014
Accepted: May 19, 2014
Published online: August 7, 2014
Despite the great successes achieved in the fields of virology and diagnostics, several difficulties affect improvements in hepatitis C virus (HCV) infection control and eradication in the new era. New HCV infections still occur, especially in some of the poorest regions of the world, where HCV is endemic and long-term sequelae have a growing economic and health burden. An HCV vaccine is still no available, despite years of researches and discoveries about the natural history of infection and host-virus interactions: several HCV vaccine candidates have been developed in the last years, targeting different HCV antigens or using alternative delivery systems, but viral variability and adaption ability constitute major challenges for vaccine development. Many new antiviral drugs for HCV therapy are in preclinical or early clinical development, but different limitations affect treatment validity. Treatment predictors are important tools, as they provide some guidance for the management of therapy in patients with chronic HCV infection: in particular, the role of host genomics in HCV infection outcomes in the new era of direct-acting antivirals may evolve for new therapeutic targets, representing a chance for modulated and personalized treatment management, when also very potent therapies will be available. In the present review we discuss the most recent data about HCV epidemiology, the new perspectives for the prevention of HCV infection and the most recent evidence regarding HCV diagnosis, therapy and predictors of response to it.
Core tip: Challenges and opportunities will characterise the story of hepatitis C virus (HCV) infection also in the new era. Despite the great therapeutic advances, improvements in HCV surveillance, epidemiological mapping, testing, prevention and therapy are urgently needed. Currently HCV vaccine candidates have shown promising results in animal models and data from clinical phase 1/2 trials are expected. Predictors of response to therapy represent a chance for modulated and personalized treatment management, when also very potent therapies will be available. The ultimate goal of global HCV control will be achieved with the joint efforts of researchers and public health workers.