Abstract
Despite successful treatments, hepatitis C virus (HCV) infections continue to be a significant world health problem. High treatment costs, the high number of undiagnosed individuals, and the difficulty to access to treatment, particularly in marginalized susceptible populations, make it improbable to achieve the global control of the virus in the absence of an effective preventive vaccine. Current vaccine development is mostly focused on weakly immunogenic subunits, such as surface glycoproteins or non-structural proteins, in the case of HCV. Adjuvants are critical components of vaccine formulations that increase immunogenic performance. As we learn more information about how adjuvants work, it is becoming clear that proper stimulation of innate immunity is crucial to achieving a successful immunization. Several hepatic cell types participate in the early innate immune response and the subsequent inflammation and activation of the adaptive response, principally hepatocytes, and antigen-presenting cells (Kupffer cells, and dendritic cells). Innate pattern recognition receptors on these cells, mainly toll-like receptors, are targets for new promising adjuvants. Moreover, complex adjuvants that stimulate different components of the innate immunity are showing encouraging results and are being incorporated in current vaccines. Recent studies on HCV-vaccine adjuvants have shown that the induction of a strong T- and B-cell immune response might be enhanced by choosing the right adjuvant.
Highlights
Chronic hepatitis C (CHC) is usually established in 75% of patients exposed to hepatitis C virus (HCV), who remain positive for HCV RNA after the acute phase [7]
Several hepatic cells may sense HCV infection and contribute to the development of the antiviral immune response. These cells can be divided into two groups: (1) non-immune cells, which include hepatocytes, the main target for HCV replication; (2) professional hepatic immune cells, which include antigen-presenting cells (APCs), such as Kupffer cells (KCs) and dendritic cells (DCs), which link the innate immune response and the adaptive immune response
The development of new adjuvants is an exciting area of vaccinology guided by the increasing knowledge of how the innate immune response can be activated and how it triggers an adaptive immune response
Summary
The hepatitis C virus (HCV) is a member of the Hepacivirus genus, Flaviviridae family. HCV is a virus with an envelope and a positive-sense single-stranded RNA genome. HCV has a high genetic diversity that has given rise to seven major genotypes and more than 60 subtypes [2]. The level of genetic diversity is approximately 30% between genotypes and 15% between subtypes of the same genotype. HCV shows high genetic diversity in each of the individuals infected (up to 10%), since HCV exists as a viral quasispecies generated by the errors of the HCV polymerase and the HCV replication rate, which are very elevated [2,3,4]. HCV employs the generation of genetic variants, viral quasispecies, to evade the adaptive immune response.
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