Hepatitis C Virus
In the past 9 years, Paul Klenerman and his team at the Peter Medawar Building for Pathogen Research have developed a picture of the cellular immune responses to Hepatitis C Virus (HCV). Their data suggest that T cells play a very important role in determining the outcome of disease. T cell responses to HCV are linked to clearance of the virus in acute infection. Pre-existing T cell responses or responses modulated on treatment may be linked to therapeutic outcome or long term progression of the disease.
HCV can be treated with interferon and ribavirin, with a successful outcome in about 50% of cases, if the strain of virus is the common one (genotype 1). The mechanism of action of both drugs is not fully established, but there is an immunomodulatory component. There is a strong need to develop better methods to predict outcome to treatment and monitor treatment response. In the case of Hepatitis B Virus (HBV), this is partly possible by monitoring the serologic response, but no such markers exist for HCV.
The Translational Immunology lab and the Medawar lab are combining to generate a series of assays to analyse the progression of HCV and define the key predictors of disease progression. This includes measurement of the viral variation within patients, the T cell response to the whole virus genome and the cytokine responses in blood.
The benefits would be improved prognostic accuracy, improved selection for therapy, and potentially improved therapeutic outcome, with substantial benefits to patients and the NHS. We are working with the vaccines theme and the cohort theme to test new vaccines for HCV in healthy donors (preventive vaccine) and in infected patients (therapeutic vaccines).
