Major models of HCV infection

HCV is one of the major causes of liver disease worldwide and has a high risk of progress in cirrhosis and hepatocellular carcinoma, the incidence of which is increasing. Currently, the licensed standard treatment for HCV infection is pegylated IFN-alpha and ribavirin; in HCV genotype 1-infected patients, the first-generation HCV NS3/4 protease inhibitors telaprevir and boceprevir may be added to the standard of care with higher antiviral potency. Although the sustained viral response rate of treatment has improved over the years, this therapy is not effective in all patients. In addition, several toxic side effects, complication and high cost limits patient compliance and the efficacy of the treatment. There is no easy model of HCV infection, and it is necessary to develop useful in vitro and in vivo models to study the pathobiology of HCV infection, including early events of acute infection (viral entry, immunological mechanisms and genetic predictors), as well as to evaluate the potency of the HCV antiviral drugs and vaccines. This article summarizes the in vitro and in vivo models that are currently used for the study of HCV infection, elucidating the early events of acute infection. This is a major issue that will probably allow us to reduce the risk of chronicity and aid the development of prophylactic and therapeutic vaccines.