[Molecular mechanisms of hepatitis C virus (HCV) replication - implications for the development of antiviral drugs]

More than 20 years after the discovery of the hepatitis C virus (HCV), chronic hepatitis C still is a major medical problem. According to the World Health Organisation 120 to 180 million people are chronically infected with HCV, with 5 million infected individuals living in Western Europe. These people have a high risk to develop serious liver disease such as liver cirrhosis and hepatocellular carcinoma (HCC). The standard-of-care therapy is not satisfying and there is no vaccine in sight. Owing to intense research activities, most notably the development of adequate cell culture systems, important insights into the viral replication cycle have been gained and several strategies used by HCV to overcome immune responses have been identified. Adequate cell culture systems also provided the basis for the development of potent and selective antivirals for treatment of chronic hepatitis C and it is expected that NS 3 / 4A protease inhibitors will be approved for clinical use in 2011 / 2012. Nevertheless, important questions are still unanswered and they will keep clinicians and basic researchers busy for the coming years.