Pathogenesis, natural history, treatment, and prevention of hepatitis C.
Approximately 4 million persons in the United States and probably more than 100 million persons worldwide are infected with hepatitis C virus. The virus has the unique ability to cause persistent infection in susceptible hosts after parenteral or percutaneous transmission, and its underlying mechanisms are not well understood. The immunologic correlates of protection and viral clearance and the pathogenesis of liver injury are yet to be defined, but recent studies suggest the importance of cell-mediated immune responses. Although 70% to 80% of infected persons become chronic carriers, most have relatively mild disease with slow progression. However, chronic and progressive hepatitis C carries significant morbidity and mortality and is a major cause of cirrhosis, end-stage liver disease, and liver cancer. Development of an effective hepatitis C virus vaccine is not imminent, but recent advances in technology and basic knowledge of molecular virology and immunology have engendered novel approaches to the fundamental problems encountered in vaccine development. Current therapy for hepatitis C, although effective in some patients, is problematic and still evolving. Advances in modern biology and immunology promise new therapies for this important disease.
Liang
T J
TJ
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-1800, USA.
Rehermann
B
B
Seeff
L B
LB
Hoofnagle
J H
JH
D000917:Antibody Formation; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000502:physiology; D006526:Hepatitis C / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007111:Immunity, Cellular; D007372:Interferons / Q000627:therapeutic use; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D014481:United States; D014761:Viral Hepatitis Vaccines
D000998:Antiviral Agents; D014761:Viral Hepatitis Vaccines; D012254:Ribavirin; D007372:Interferons