Therapeutic vaccines against the hepatitis C virus in the age of direct-acting antivirals

Hepatitis C is a significant health problem worldwide, with incidence estimates around 160 million people and 500 000 annual deaths. The limited success of treatments in chronic genotype 1 hepatitis C virus (HCV) patients and the numerous and significant adverse effects of the therapeutic treatment with pegilated interferon and ribavirin have encouraged the development of different direct-acting antivirals (DAAs) with promising results. This was also stimulated by advances of the knowledge on virus cell cycle and the properties of its structural properties. However, DAAs are very expensive and some of those compounds have developed multiple adverse events, all these limiting their use in certain infected populations. Moreover, its use does not prevent from HCV reinfections. Hence, new treatments, such as therapeutic vaccines, have arisen as additional or combined therapies against chronic HCV infection.