Fresh assault on hepatitis C

摘要

As researchers gradually got to grips with viruses that attack the liver, two were identified early on―hepatitis A and hepatitis B. But clearly there were more, because there were also cases of hepatitis that had the hallmarks of neither virus. These cases occurred following blood transfusion, and for some time the resulting disease was known as non-A, non-B post-transfusion hepatitis. The culprit, hepatitis C virus (HCV), was identified in the late 1980s. Now, nearly 15 years later, the first small-molecule inhibitors of HCV are being tested in humans. On page 186 of this issue, Lamarre et al. report spectacular success―at least in short-term trials―with an orally administered inhibitor of a viral protease, an enzyme that is essential for HCV to reproduce itself. Hepatitis C is a severe medical problem. After the identity of the virus was revealed, the advent of reliable diagnostic methods led to the realization that here was a global infection afflicting some 170 million people. It is transmitted by contaminated blood, fortunately now rare in transfusions. Chronic―persistent―infection is typical, and the disease course is unpredictable: some people seem to be unaffected, whereas others develop cirrhosis, end-stage liver disease and liver cancer. For many, a liver transplant is the only hope.