Optimizing Interferon Alfa Based Therapy for Chronic Hepatitis C

The hepatitis C virus was first discovered in 1989 as the major cause of chronic non-A non-B\nhepatitis. The hepatitis C virus is a single stranded RNA virus that belongs to the family of\nflaviviruses. The primary target of the hepatitis C virus are hepatocytes where viral particles\nreplicate extremely fast with the production of 1012 viral particles per day. Worldwide 6 major\nHCV genotypes occur whose prevalence varies geographically. The predominant risk factor\nfor infection is injection drug use. Other risk factors include blood transfusions before 1992,\nhigh lifetime number of sexual partners and iatrogenic transmission. Infection with the\nhepatitis C virus leads to a chronic infection in 55-80% of patients. A recently discovered\nsingle nucleotide polymorphism near the IL-28b gene is associated with spontaneous clearance\nof the hepatitis C virus.\nWorldwide 180 million people suffer from chronic hepatitis C virus (HCV) infection with 3-4\nmillion people newly infected people and more than 350000 deaths each year. Although\nthe natural history of chronic hepatitis C is highly variable, approximately 15-30% of patients\ninfected with HCV will develop liver cirrhosis over the ensuing 3 decades. Cirrhosis can\nlead to the development of hepatocellular carcinoma and end stage liver disease. Consequently,\nchronic HCV infection is the leading indication for liver transplantation in developed\ncountries.\nThe primary goal of antiviral treatment for chronic hepatitis C is to prevent complications and\ndeath from HCV infection. This goal can be achieved by eradicating the virus permanently.