[Gene therapy approaches in chronic viral hepatitis]

The clinical and socioeconomic background of chronic viral hepatitis is favourable to new therapeutic approaches based on gene biochemistry. As with all gene therapy, the treatment of chronic viral hepatitis using this approach would make use of a therapeutic gene and a delivery system adapted to the pharmaceutical objectives of targeting, gene expression and kinetics. The various vectors under review are not yet sufficiently optimized for selective targeting of infected hepatocytes. Moreover, four therapeutic gene processes are currently under development: antisense oligonucleotides, ribozymes, dominant negative mutants and DNA vaccines. These developments are obviously limited by the lack of experimental or animal models representative of the pathophysiology of chronic viral hepatitis. The gene therapy for chronic viral hepatitis is nearly ready for clinical evaluation but must be weighed against the continuous progress of pharmaceutical treatments.