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Hepatitis C Virus (HCV)


HCV is a dangerous and often fatal virus, with more than 170 million persons are infected with HCV worldwide. Since most patients infected with HCV (up to 85%) develop chronic liver disease, including chronic hepatitis, cirrhosis, and hepatocellular carcinoma, HCV is spread primarily by transfused blood products or among drug users by contaminated needles. The estimated percentage in France is near 1% meaning 500,000 to 600,000 people.
High risk groups include injection drug users, multiple transfusion and organ transplant recipients, and hemodialysis patients. As many as 40% of patients with HCV have no known risk factors, and other modes of transmission are believed possible.


In occidental countries, HCV is responsible of:
  • 20% of acute hepatitis,
  • 70% of chronic hepatitis
  • 40% of “décompensées” cirrhosis

Causative agents


The Hepatitis C Virus is a RNA (Ribonucleic acid) virus with a highly variable genome. There are 6 main genotypes (matched 1 to 6) which are subdivided in very numerous subtypes identified by small letters (nearly 80 subtypes are now known). HCV genotypes can be used as epidemiological markers due to their variants distribution worldwide.

Transmission


The HCV is basically transmitted by the blood route. The two main risk factors are blood transfusion and drug addiction. Sexual and in utero transmissions are very rare.

Diagnosis


For screening there are ELISA tests using anti-C Virus antibodies. In high risk populations, a positive serologic ELISA test has to be confirmed by C Virus RNA detection test using PCR technique providing virus detection by amplification.

Treatments


The current cure standard is combination of two antiviral drugs: “pegyled” alpha-2b interferon plus ribavirin. The “pegyled” interferon is a new alpha interferon form with slow release and more prolonged action; they have antivirus and immune system stimulating actions. Ribavirin interferes with reproduction mode of virus and raise interferon efficiency too.


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