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<p>The introduction of direct-acting antiviral (DAA) therapy has been a game-changer in the elimination of hepatitis C virus infection. DAAs treatment achieved higher rates of sustained virological response among HCV-infected individuals across different virus genotypes. DAAs directly target HCV viral several proteins in the HCV lifecycle resulting in controlling the infection. So far, the immune system also plays a crucial role in effective viral eradication. Prolonged antigen exposure, coupled with high viral loads, are key factors that drive immune system failure and the development of chronic infection. T cell exhaustion is the hallmark of the failure of immune response to eliminate the infection. Several sequelae contribute to T cell exhaustion, including the failure of CD8+ and CD4+ T cells, the expansion of the immune suppressive effects of regulatory T cells, and the modulation of epigenetics, which collectively contribute to the persistence of HCV infection. The interplay between DAA therapy and the influence on immune response particularly T cell exhaustion is still an opening question. In this review, we shed light on the recent studies exploring the impact of DAA therapy on CD8+ and CD4+ T cell response as well as the epigenetics change. We also aim to bridge the gap in the new approaches to HCV control.</p>

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Unveiling the nexus between direct-acting antivirals in hepatitis C virus elimination and immune response

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月30日

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  • Aya I. Abdelaziz,
  • Eman Abdelsameea,
  • Sara A. Wahdan,
  • Doaa Elsherbiny,
  • Zeinab Zakaria,
  • Samar S. Azab

摘要

The introduction of direct-acting antiviral (DAA) therapy has been a game-changer in the elimination of hepatitis C virus infection. DAAs treatment achieved higher rates of sustained virological response among HCV-infected individuals across different virus genotypes. DAAs directly target HCV viral several proteins in the HCV lifecycle resulting in controlling the infection. So far, the immune system also plays a crucial role in effective viral eradication. Prolonged antigen exposure, coupled with high viral loads, are key factors that drive immune system failure and the development of chronic infection. T cell exhaustion is the hallmark of the failure of immune response to eliminate the infection. Several sequelae contribute to T cell exhaustion, including the failure of CD8+ and CD4+ T cells, the expansion of the immune suppressive effects of regulatory T cells, and the modulation of epigenetics, which collectively contribute to the persistence of HCV infection. The interplay between DAA therapy and the influence on immune response particularly T cell exhaustion is still an opening question. In this review, we shed light on the recent studies exploring the impact of DAA therapy on CD8+ and CD4+ T cell response as well as the epigenetics change. We also aim to bridge the gap in the new approaches to HCV control.