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重磅声音∣丙肝病毒研究在当前强效抗病毒治疗的时代所面临的严峻挑战和新机遇:源于科学家和资助机构的思考

【据《Virus Res》2018年2月15日报道】题:丙肝病毒研究在当前强效抗病毒治疗的时代所面临的严峻挑战和新机遇:源于科学家和资助机构的思考(作者Ralf B等)

直接抗病毒药物(DAAs)的研发和临床应用对慢性丙型肝炎的治疗产生了革命性的影响。任何丙肝病毒基因型的感染者,甚至终末期肝病和肝移植患者均可通过口服短疗程且耐受良好的药物清除丙肝病毒,治愈率高于95%。

DAAs的成功致使一些研究者认为HCV可以被根除,因此继续研究该病毒已经没有临床价值。然而,鉴于每年仍有40万HCV相关的死亡病例,严峻的挑战仍然存在,包括确诊感染者,对感染者进行治疗和降低治疗费用。

除此之外,丙肝病毒感染很少会诱导消除性免疫,因此已经被DAAs治愈的患者仍然面临再次感染的危险。

因此,在没有疫苗的情况下,全球范围内根治和消除丙肝相关癌症的可能性很小。然而,丙肝疫苗方向的研究却很少受到关注。

在过去的二十年里,HCV的研究已经给分子细胞生物学、免疫学和微生物学等领域带来了大量的重要发现。考虑到在DAAs的开发和临床应用过程中所积累的材料试剂和知识信息,HCV的研究将继续为这些基础研究领域做出贡献。鉴于目前所面临的这些严峻挑战和新机遇,我们认为对HCV研究的资助必须持续进行。

吉林大学第一医院 刘丽莉,潘修竹/报道钟劲教授点评

这篇综述是由包括2016年拉斯克医学奖获得者Bartenschlager和Rice教授在内的12名丙肝病毒研究领域的知名学者共同完成。近年来随着新型高效抗丙肝药物的不断推出,慢性丙肝的临床治疗得到了很大的改善,不少人开始认为丙肝的根除指日可待,一些国家的科研基金资助机构也开始或计划开始削减丙肝研究的经费。这篇综述总结了当前丙肝研究的重要临床需求及尚需解决的关键科学问题,指出了继续开展丙肝基础和转化应用研究的必要性。这篇云集重量级科学家的综述发出的声音也给各国科研基金资助机构提供了重要的参考意见。

钟劲

中国科学院, 特聘研究员(特聘核心骨干)

上海科技大学, 特聘教授

中国科学院上海巴斯德研究所, 研究员,研究组长,所长助理

Critical challenges and emerging opportunities in hepatitis C virus research in an era of potent antiviral therapy: Considerations for scientists and funding agencies

Ralf Bartenschlager, Thomas F. Baumert, Jens Bukhf, Michael Houghton, et al.

The development and clinical implementation of direct-acting antivirals (DAAs) has revolutionized the treatment of chronic hepatitis C. Infection with any hepatitis C virus (HCV) genotype can now be eliminated in more than 95% of patients with short courses of all-oral, well-tolerated drugs, even in those with advanced liver disease and liver transplant recipients.

DAAs have proven so successful that some now consider HCV amenable to eradication, and continued research on the virus of little remaining medical relevance.However, given 400,000 HCV-related deaths annually important challenges remain, including identifying those who are infected, providing access to treatment and reducing its costs.

Moreover, HCV infection rarely induces sterilizing immunity, and those who have been cured with DAAs remain at risk for reinfection.

Thus, it is very unlikely that global eradication and elimination of the cancer risk associated with HCV infection can be achieved without a vaccine, yet research in that direction receives little attention.

Further, over the past two decades HCV research has spearheaded numerous fundamental discoveries in the fields of molecular and cell biology, immunology and microbiology. It will continue to do so, given the unique opportunities afforded by the reagents and knowledge base that have been generated in the development and clinical application of DAAs. Considering these critical challenges and new opportunities, we conclude that funding for HCV research must be sustained.

2018-03-09 08:52:07   10
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