[Immunomodulating effect of HCV during the development of chronic hepatitis C: toward new therapeutic approaches]

In France, HCV seroprevalence is estimated to be 1%. Most cases are related to illicit parenteral drug use. About 80% of patients infected by HCV will develop chronic infection with HCV RNA detectable in their serum. Factors involved in viral persistence are nor yet clearly identified. Patients who develop a chronic infection show a predominant Th2 response, but a weak Th1 response. This immune response imbalance could result from HCV interaction with dendritic cells functions. Several experimental and clinical studies support this hypothesis. New data on HCV strategy to establish chronic infection suggest that immmunomodulatory molecules could be useful to improve efficacy of therapy.