Document 0111
 DOCN  M9460111
 TI    Chronic hepatitis C.
 DT    9408
 AU    Sherlock DS; Department of Medicine, Royal Free Hospital School of
       Medicine,; University of London, United Kingdom.
 SO    Dis Mon. 1994 Mar;40(3):117-96. Unique Identifier : AIDSLINE
       MED/94221962
 AB    Formerly the diagnosis of acute and chronic non-A, non-B hepatitis was
       made by the exclusion of other causes. However, in 1989 cloning of an
       antigenic component of the hepatitis C virus (HCV) was reported. This
       led to first- and second-generation tests for antibody to HCV (anti-HCV)
       in serum. HCV has been associated with acute and chronic posttransfusion
       and sporadic non-A, non-B hepatitis, and with hepatocellular carcinoma.
       Viral HCV RNA can be estimated with the polymerase chain reaction test,
       but this technically difficult test is not generally available. The
       entire viral genome has been sequenced. The envelope region shows
       considerable variation, and mutant HCV infections are being described
       already. There are geographic variations in the prevalence of anti-HCV,
       but usually about 0.5% to 1% of healthy blood donors test positive.
       Parenteral exposure to blood, especially by transfusion or drug abuse,
       remains a certain means of acquiring HCV infection. The method by which
       millions without parenteral risk factors acquire HCV remains uncertain.
       Vertical transmission and sexual and family spread occur only rarely.
       Body secretions are free of the virus. The mode of transmission may
       become clarified when tests for viral HCV as opposed to anti-HCV become
       generally available. Acute HCV infection usually is mild, and the
       chronic disease is also indolent. Carriers of hepatitis B virus or
       alcoholics who also test positive for HCV have more serious disease.
       Chronic HCV infection must be distinguished from autoimmune chronic
       active hepatitis. The most important difference is the response to
       corticosteroid therapy, which is good in autoimmune hepatitis and poor
       in HCV-related disease. Hepatocellular carcinoma can complicate
       HCV-related cirrhosis, usually about 20 years after infection with HCV.
       Recombinant interferon-alpha is used to treat chronic HCV disease, but
       selection of patients, dose, and duration of therapy are uncertain. In
       general, 50% of patients respond to the treatment, but 50% of these will
       have a relapse, with an overall response rate of 25%. Liver
       transplantation in patients with end-stage HCV disease usually is
       followed by infection of the graft.
 DE    Alcohol Drinking/ADVERSE EFFECTS  Antiviral Agents/THERAPEUTIC USE
       Autoimmune Diseases/COMPLICATIONS  Blood Transfusion/ADVERSE EFFECTS
       Cloning, Molecular  *Hepatitis
       C/COMPLICATIONS/DIAGNOSIS/EPIDEMIOLOGY/ETIOLOGY/
       MICROBIOLOGY/PATHOLOGY/THERAPY/TRANSMISSION  Hepatitis C
       Viruses/GENETICS  Human  HIV Infections/COMPLICATIONS
       Interferons/THERAPEUTIC USE  Liver/PATHOLOGY  Liver Cirrhosis/ETIOLOGY
       Liver Transplantation  Substance Abuse, Intravenous/COMPLICATIONS
       JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).