Hepatitis C Virus

摘要: Hepatitis C virus (HCV) is a flavivirus that endemic worldwide. Six genotypes are commonly recognized; seventh rare genotype has been identified. Given its relative prevalence, this chapter focuses on 1 through 4. HCV transmitted by blood-borne routes. Most acute infections asymptomatic and progress to chronicity. Chronic also until significant liver damage occurs. Pegylated alpha interferon plus ribavirin was the only treatment for many years. Highly potent, pan-genotypic, interferon-free direct-acting antiviral (DAA) regimens cure >95% of clinical-trial subjects have developed will dramatically improve treatment. Routine diagnostics include serology, RNA detection/quantification assays, genotyping assays. Newer diagnostic tests characterization host at loci upstream IL28B associated with responsiveness, detect drug resistance mutations. Serology useful after known exposure identify infection. used screen chronic infection; seropositive individuals then tested assays viral load determined prior initiation. In pre-DAA era, predict likelihood response. It helpful determine regimen therapeutic duration; these two uses remain relevant DAAs. Viral testing during therapy likely still be performed assessment medication compliance. may retain some importance in predicting response rates interferon-containing regimens. Drug thus far limited applicability.