Hepatitis C Virus Infection: Detection and Treatment

Matthew L Rubinstein; Mary E Miele

doi:10.29074/ascls.16.4.203

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Matthew L Rubinstein
1. is in the Department of Pathology–Virology/Immunology, University Health System, San Antonio TX
Mary E Miele⇑
1. is in the Department of Medical Technology, University of Delaware, Newark DE

Address for correspondence: Mary E Miele PhD, University of Delaware, Department of Medical Technology, 305 Willard Hall Education Building, Newark DE 19716. (302) 831-8591, (302) 831-4180(fax). mmiele{at}udel.edu

Extract

Hepatitis C virus (HCV) is a blood-borne virus that infects the liver. HCV affects millions of Americans, and poses a serious public health threat with sequelae such as cirrhosis, hepatocellular carcinoma, and liver failure. This paper reviews means of transmission, characteristics of the various risk groups, and clinical presentations of both the acute and chronic stages of HCV infection. Diagnostic methods, including screening and confirmatory tests, along with relevant clinical and physiologic findings are also described. Additionally, treatment strategies, in particular combination therapy with interferon α-2b and ribavirin, are discussed. Contraindications, side effects, and monitoring of this therapeutic modality are considered. Finally, prospective treatments are presented.

Hepatitis C is the most common blood-borne infection and is the leading cause of chronic liver disease.¹ In the United States, approximately four million people are infected with Hepatitis C virus. Nearly three million of those are in the chronic stage and about forty thousand new cases occur each year.^2-4 HCV infection has a 1% to 2% mortality rate with approximately 10,000 deaths occurring annually in the United States.² One of several hepatitis viruses (A through G), hepatitis C accounts for 20% of viral hepatitis cases and is potentially the most harmful to the host because of its propensity to cause chronic infection and severe liver damage often requiring liver transplants.^3,5

The hepatitis C virus (HCV) is a small, enveloped, singlestranded RNA virus of the family Flaviviridae, and has a genome of 9.6 kilobases coding for structural and non-structural proteins.^6,7 HCV has a high…

ABBREVIATIONS: ALT = alanine aminotransferase; AST = aspartate aminotransferase; EIA = enzyme immunoassay; FDA = Food and Drug Administration; GGT = gamma glutamyltransferase; HCV = hepatitis C virus; NAT = nucleic acid amplification testing; PKR = RNA-dependent protein kinase; PT = prothrombin time; RIBA = recombinant immunoblot assay; RT-PCR = reverse transcription-polymerase chain reaction; URL = upper reference level.