Targets of protective immunity and opportunities in hepatitis C virus vaccine development

Hepatitis C virus (HCV) remains a serious global health burden that affects nearly 50 million people worldwide. Despite the availability of highly effective direct-acting antiviral drugs, the lack of an effective HCV vaccine hinders control and elimination worldwide, wherein new infections and overall prevalence remain high. HCV vaccine development faces challenges including high genetic diversity of the virus, unclear correlates of protective immunity, and lack of robust in vivo models for vaccine testing. Despite these obstacles, the landscape of HCV vaccine development is rapidly evolving. Innovative strategies, including subunit, virus-like particle, viral vector, DNA and RNA vaccines, show promising results, and controlled human infection models offer a unique, albeit ethically complex, opportunity to accelerate vaccine development. Collaborative efforts among academia, industry, governmental agencies and regulatory bodies are crucial for optimizing vaccine strategies, overcoming current challenges and effecting advances towards global HCV elimination through vaccination.