Hope for the eradication of HCV worldwide

Abstract

The mission of the ANRS (the French National Agency for Research on AIDS and viral hepatitis) is to coordinate research, schedule appropriate events and meetings and fund projects on HIV and viral hepatitis. The Agency was created in 1988 to coordinate research on HIV/AIDS and as of 1 January 1999, the ANRS’ mission was expanded to include the task of coordinating and funding hepatitis C basic science and public health research. This role was expanded at the beginning of 2005 to all research on hepatitis B and C. Within a relatively limited time-frame, the ANRS was able to transfer its acquired HIV experience and adapt its reactivity and flexibility to the issues presented by hepatitis B and C clinical and public health research. As such, since 1999, the ANRS has funded 32 therapeutic trials, 31 physiopathological clinical research projects, four cohorts and over 300 basic research projects in the field of viral hepatitis. To reinforce research in the Middle East and Africa in 2007, the Agency created the ANRS site in Egypt, dedicated to clinical and basic research on hepatitis C genotype 4 (HCV-4). The ANRS-funded projects led by university or clinical researchers result in, on average, 500 peer-reviewed publications per year on both HIV and viral hepatitis research, half of which are published in journals with an impact factor >5. At an international level, a survey carried out by Inserm shows that France is ranked second for hepatitis research (9.3% of total publications). In 2011, the ANRS dedicated approximately 22% of its global budget to research in the domain of viral hepatitis. The ANRS funds research projects in all disciplines including basic research projects, pre-clinical, clinical studies and projects in social sciences. Moreover, the ANRS is currently funding a vaccine research programme for Hepatitis C, carried out at the Vaccine Research Institute (VRI) in partnership with Université Paris Est Créteil. In basic research, several aspects of hepatitis entry, assembly, replication and interaction with host cells are ANRS research priorities. In particular, the ANRS funds research in the following areas: The ANRS also supports a consortium of research groups devoted to the development and standardization of animal models, including humanized mouse models for studying viral hepatitis. In addition, in collaboration with Inserm and the Universities of Paris VI and XI, the ANRS has set up a genomic platform on the site of the Pitié-Salpetrière Hospital. The platform is set up for ultra-deep sequencing for genotype/phenotype association studies. The platform provides support for both hepatitis and HIV research. Despite notable progress in clinical research in the field of B and C viral hepatitis in recent years, a number of questions regarding patient care and the evolution of the disease remain unanswered. The ANRS therefore remains thoroughly involved in therapeutic trials, cohorts and physiopathology studies in the domain of viral hepatitis. The ANRS supervises a unique clinical network in the field of viral hepatitis research in France, comprising 28 clinical units. Moreover, the agency funds 23 staff positions for Clinical Research Associates. The current patient register for HBV-/HCV-infected individuals is over 69 000; 700 patients are included in clinical trials and 2700 in cohorts, not including HIV/hepatitis co-infected patients. The ANRS has strong ties with patient associations and community-based organisations, namely CHV (Collectif Hépatites Virales), which regroups several hepatitis organisations, including in particular SOS Hépatites. The associations provide advice on study protocols, in particular on trial information and patient consent sheets. In general terms, patient care needs to be improved, and patients with treatment-failure need to be able to access novel combinations of molecules. Inversely, patients with successful therapies could benefit from simplified or shorter drug regimens. Among our current priorities in clinical research on viral hepatitis are: Treatment options for chronically infected persons are at a paradigm shift. The two first-generation protease inhibitors, boceprevir and telaprevir, have been released in 2011 and are now to be used in the real-world. More than 70 new products directed against hepatitis B virus (HBV) and hepatitis C virus (HCV) are under clinical development. The ANRS has played a strong role in this therapeutic development by providing innovative support to the hepatitis community. Viral Hepatitis mono-infection The author has no disclosure.