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From Bench to Bedside: Hope for HCV Vaccine

The World Health Organization (WHO) states that an estimated of 130-150 million people are affected with hepatitis C worldwide, and the number is on the rise every year.

According to it, 55–85% of the world’s HCV patients will develop chronic HCV infection, and within 20 years, about 15–30% of whom can become liver cirrhosis patients.

Researchers at the Medicine School of Johns Hopkins University succeeded in uncovering how antibodies interact with hepatitis C virus which causes liver inflammation.

Those researchers placed together with other promising researches will hopefully help towards developing a vaccine for this dangerous disease.

At the Hepatitis Research Clinic at John Hopkins University, in order to better understand how the HCV avoid the broad range of antibodies, scientists recently tested 18 antibodies that are known to broadly attack the virus against viral strains that represent most of the genetic variability of the HCV.

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When these antibodies were tested against viruses isolated from infected people, the same level of resistance as to what occurred with the patient’s own antibodies was observed.

Hepatitis is an inflammation of the liver. Unfortunately, the disease has many causes but it’s mainly transmitted through being in contact with the blood of an infected person and is most commonly done so by sharing needles, unhygienic healthcare facilities and sharing of personal hygienic equipment like in nail salons and tattoo parlours.

Unfortunately, the virus enters the body without any signs or symptoms, and is first observed with the diagnosis of an infected and in some cases a damaged liver.

The disease leads to an acute and a chronic infection, with some cases leading to cirrhosis; complete loss of liver function.

HCV unfortunately can lead to chronic cirrhosis. Cirrhosis itself isn’t apparent until after many years, and many with it gradually develop liver cancer or other life threatening conditions, according to the US’s Centers for Disease Control and Prevention (CDC).

In rare and severe cases, the virus also has the potential to damage other parts of the body, including the digestive system, the immune system and the brain, as the CDC put it.

Although they all attack the liver, MedicineNet, Inc. informs that Hepatitis A and B are acute and common, and not as deadly as the hepatitis C. Most importantly, we have vaccines that protect against them.

Hepatitis C has seven different types of viruses, which all have different genetic structures, called genotypes, numbered from 1-7.

As mentioned by MedicineNet, Inc. the virus itself is highly variable. When infected, not everyone diagnosed with it go on the road to chronic liver disease.

“Some, in fact 25% of people worldwide who get infected are able to completely eliminate the virus from their systems. The response that is exhibited is affected by many factors; genetics and the environment,” said Naglaa Shoukry, an Egyptian hepatitis C researcher and a professor at University of Montreal, Canada.

Current Treatments

For some HCV patients, the condition can be self-limiting (healing on its own) whereas for others, its progression can be treated or become life threatening.

Angela Yeung, Microbiology professor at the Department of Biology at the University of Ottawa, Canada told AboutIslam there are treatments which are a combination of drug therapy, but this is based on a number of criteria such as the HCV genotype, viral load, degree of liver damage in addition to other factors. The virus is fast-mutated in the liver.

The current treatment, which will soon come to an end, is a combination of interferon (a signaling protein that interferes with viral replication) and ribavirin (stop viral production), Yeung and Shoukry told AboutIslam.net.

Some treatments like Sovaldi (inhibit the production of the virus) which was developed by an Egyptian Jew, Dr. Raymond F. Schinazi, are very expensive, costing about $1000 a day and $84,000 for a 12-week treatment.

Yeung makes it clear that the virus replicates in the liver, and mutates rapidly due to the high amount of error rate on the enzyme named RNA dependant RNA polymerase.

Shoukry, in terms of the current treatments, explained to AboutIslam.net that the new treatments are now given in combination with Sovaldi and other new treatments that don’t contain interferon.

These treatments are soon to be available to the general public4. One is considered cured if the tests done for six consecutive months don’t reveal any signs of the presence of the virus in the bloodstream.

The New Hope

Like all the vaccines that aim to protect against a specific type of virus, a hepatitis C vaccine will be capable of protecting against the HCV.

Unlike the vaccines for Hepatitis A and B, the vaccine for hepatitis C is currently under development. And it will be significantly different from other vaccines.

Most vaccines induce an antibody response, targeting the outer surfaces of the virus.

However, the HCV virus is highly variable and fast-mutated, making the development of a vaccine very difficult. The virus is able to put on a disguise, which hinders the antibodies from finding them4.

Given the variable and ever changing nature of the HCV, one given antibody isn’t sufficient. In order to combat this, a vaccine which works by inducing T-cells, the cellular arm of the immune system, is being studied.

“Part of the vaccine works by sneaking into the body through a chimpanzee cold virus that human immune systems won’t know to kill,” said Dr. Ellie Barnes, co-author and professor of hepatology and experimental medicine at the University of Oxford, England.

“Therefore, in order to successfully develop one, it’s necessary to form the vaccine as a combination that works using both of the immune responses—the humoral, which works by generating antibodies and the cellular, which works by creating immune cells that recognize the infected liver cells and kill them,” Shoukry told AboutIslam.

According to Shoukry, the vaccine shouldn’t be too expensive. It may not be too long before we see the vaccine become a reality in the world of medicine.

This article is from Science’s archive and we’ve originally published it on an earlier date.

References:

1. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 15 Apr. 2015. Web. 07 May 2015.

2. “Hepatitis C.” WHO. N.p., n.d. Web. 11 May 2015.

3. ScienceDaily. ScienceDaily, n.d. Web. 14 May 2015.

4. “Vaccine for Hepatitis C Inches Closer to Reality.” Consumer HealthDay. N.p., n.d. Web. 20 May 2015.

About Madiha Sadaf
Madiha Sadaf in an undergraduate student at the University of Ottawa, enrolled in BSc. with Major in Biology and Psychology with Minor in Health Social Sciences.