Directly acting antivirals (DAAs) can now stop it and therefore prevent the liver cirrhosis and liver cancer that can develop. Next up, said Professor Sir Michael Houghton at the European Society of Clinical Microbiology and Infectious Diseases, who won the Nobel Prize for Medicine and Physiology along with three other scientists for discovering it was distinct in 1989, is a vaccine.
Prevention is always cheaper than cure. Countries like Egypt have managed to enact control programs for hepatitis C (50 million screened and 4 million treated and cured using DAAs since 2014), but that is only thanks to mass production of generic drugs which drop the cost to $84 per patient. But generic drugs are not sustainable, no company can afford to do discovery if they can't make money on them, and academia and government cannot do applied science at all. So before poor countries can get drugs for $80 a person, people in the US have to pay $80,000.
Since even in the US most healthcare is mandated and subsidized by government, that means everyone has to pay. The large at-risk populations are drug addicts and men who have unprotected sex and awareness and education have not helped enough. The COVID-19 pandemic, and success of mRNA technology to reproduce protective immune responses through vaccination, or adenovirus-based technologies by AstraZeneca, and Johnson&Johnson, may make a vaccine affordable.
Houghton and colleagues are developing an adjuvanted recombinant vaccine, which is expected to induce production of antibodies to multiple cross-neutralising epitopes, making it harder for the virus to escape the humoral immune response. The reason is because there are many different antibodies likely to be produced by this vaccine that can prevent HCV infection, making it very hard for the virus to evade them by mutation and thus protecting the vaccine recipient from hepatitis C infection.
They anticipate phase 1 trials in 2022 using different adjuvants followed by phase 2 human efficacy trials from 2023-2026, either in an at-risk population such as people who inject drugs, or via human vaccine challenge trials. Following phase 3 trials, the hepatitis C vaccine could then be rolled out to adjacent high-risk groups, such as healthcare workers, and babies born to mothers with hepatitis C.
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