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Since studies performed nearly 50 years ago on patients with post-transfusion hepatitis indicated the existence of HCV as the cause of chronic liver disease, in discoveries recently recognised by the Nobel Prize, at least 25 million people have died from chronic sequelae of this insidious infection, including liver cirrhosis and hepatocellular carcinoma.1 Currently, at least 400 000 people die due to hepatitis C-related diseases, annually, despite the availability of curative direct-acting antivirals.2 Further, there is no prophylactic vaccine against this virus to prevent the nearly 2 million new cases annually, of which 75% result in persistent lifelong infections that for most remain undiagnosed.2 In fact, only very few vaccine candidates have advanced to clinical trials; most recently a T cell based vaccine, despite induction of robust immune responses, failed to lower the chronicity rate following HCV exposure.3 This stands in contrast to the development of effective antibody-based vaccines against SARS-CoV-2, less than 1 year after the first description of its associated disease COVID-19.4 Thus, it would be important to consider which molecular features unique to HCV virus neutralisation challenges vaccine efforts, and to seek solutions by the lessons learnt from COVID-19 to finally change the trajectory towards universal vaccination against HCV. In this issue of Gut, Bankwitz et al5 explored infectious cell culture systems to advance testing for broadly reactive neutralising antibodies (NtAb) against HCV in patients and in vaccine studies.
The HCV populations …
Correction notice This article has been corrected since it published Online First. The provenance and peer review statement has been included.
Contributors JB wrote the manuscript.
Funding This study was supported by grants from Independent Research Fund Denmark (DFF), Medical Sciences and the Novo Nordisk Foundation. JB is the 2015 recipient of the Novo Nordisk Prize and the 2019 recipient of a Distinguished Investigator grant from the Novo Nordisk Foundation. The content is solely the responsibility of the author and does not necessarily represent the official views of the funders.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; internally peer reviewed.