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A siege of hepatitis: Fighting a defiant virus

Nature Medicine volume 17, pages 253–254 (2011)Cite this article

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Hepatitis C is the leading cause of liver cancer in the US and Europe, where approximately 3% of the general populations are infected. At least 20% of untreated persons will progress to cirrhosis1, and 15% of individuals with cirrhosis will develop hepatocellular carcinoma within ten years.

In the late 1990s, it was shown that, in contrast to HIV-1 infection, hepatitis C could be eradicated with antiviral therapy. Clinical trials with 12 months of interferon and ribavirin resulted in sustained virologic response—undetectable virus 24 weeks after last dose—in 50% of subjects2,3, which correlated with viral cure, as well as a 60% decrease in overall mortality. But this regimen has incomplete and unpredictable clinical efficacy, frequent dose-related toxicities and treatment costs of approximately $35,000 per year—a source of frustration for patients and providers4.

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Figure 1: Drug resistance dynamics during hepatitis C monotherapy.

References

  1. Davis, G.L., Alter, M.J., El-Serag, H., Poynard, T. & Jennings, L.W. Gastroenterology 138, 513–521.e6 (2009).

    Article  Google Scholar 

  2. Poynard, T. et al. Lancet 352, 1426–1432 (1998).

    Article  CAS  Google Scholar 

  3. McHutchison, J.G. et al. N. Engl. J. Med. 339, 1485–1492 (1998).

    Article  CAS  Google Scholar 

  4. Ghany, M.G., Strader, D.B., Thomas, D.L. & Seeff, L.B. Hepatology 49, 1335–1374 (2009).

    Article  CAS  Google Scholar 

  5. Dahari, H., Sainz, B. Jr., Perelson, A.S. & Uprichard, S.L. J. Virol. 83, 6383–6390 (2009).

    Article  CAS  Google Scholar 

  6. Fletcher, N.F. et al. Gastroenterology 139, 1365–1374 (2010).

    Article  CAS  Google Scholar 

  7. McHutchison, J.G. et al. N. Engl. J. Med. 360, 1827–1838 (2009).

    Article  CAS  Google Scholar 

  8. Hézode, C. et al. N. Engl. J. Med. 360, 1839–1850 (2009).

    Article  Google Scholar 

  9. Rong, L., Dahari, H., Ribeiro, R.M. & Perelson, A.S. Sci. Transl. Med. 2, 30ra32 (2010).

    Article  Google Scholar 

  10. Kieffer, T.L. et al. Hepatology 46, 631–639 (2007).

    Article  CAS  Google Scholar 

  11. Cuevas, J.M., Gonzalez-Candelas, F., Moya, A. & Sanjuan, R. J. Virol. 83, 5760–5764 (2009).

    Article  CAS  Google Scholar 

  12. Gane, E.J. et al. Lancet 376, 1467–1475 (2010).

    Article  CAS  Google Scholar 

  13. Schuurman, R. et al. J. Infect. Dis. 171, 1411–1419 (1995).

    Article  CAS  Google Scholar 

  14. Roberts, S.K. et al. Hepatology 48, 398–406 (2008).

    Article  CAS  Google Scholar 

  15. Ge, D. et al. Nature 461, 399–401 (2009).

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. John Scott and Lawrence Corey are in the Department of Medicine, Joshua T. Schiffer, University of Washington, Seattle, Washington, USA.,

    Joshua T Schiffer, John Scott & Lawrence Corey

  2. Joshua T. Schiffer and Lawrence Corey are also in the Vaccine and Infectious Diseases Division, The Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,

    Joshua T Schiffer & Lawrence Corey

Authors
  1. Joshua T Schiffer
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  2. John Scott
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Correspondence to Joshua T Schiffer or Lawrence Corey.

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Competing interests

J.S. has received research funding from Genentech, Tibotec and Anadys. He serves on the Speaker’s Bureau for Genentech, Gilead, Merck and Vertex. He has served on advisory boards in the last year for Vertex.

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Schiffer, J., Scott, J. & Corey, L. A siege of hepatitis: Fighting a defiant virus. Nat Med 17, 253–254 (2011). https://doi.org/10.1038/nm0311-253

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