The Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (Review)

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dc.contributor.author Fanning, Liam J.
dc.date.accessioned 2016-06-17T14:28:47Z
dc.date.available 2016-06-17T14:28:47Z
dc.date.issued 2002-02-01
dc.identifier.citation Fanning, L. J. (2002) 'The Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (Review)', International Journal of Molecular Medicine, 9(2), pp. 179-184. http://dx.doi.org/10.3892/ijmm.9.2.179 en
dc.identifier.volume 9 en
dc.identifier.startpage 179 en
dc.identifier.endpage 184 en
dc.identifier.issn 1107-3756
dc.identifier.issn 1791-244X
dc.identifier.uri http://hdl.handle.net/10468/2756
dc.identifier.doi 10.3892/ijmm.9.2.179
dc.description.abstract The aetiological agent of chronic hepatitis C is the hepatitis C virus. The hepatitis C virus is spread by parenteral transmission of body fluids, primarily blood or blood products. In 1989, after more than a decade of research, HCV was isolated and characterised. The hepatitis C viral genome is a positive-sense, single-stranded RNA molecule approximately 9.4 kb in length, which encodes a polyprotein of about 3100 amino acids. There are 6 main genotypes of HCV, each further stratified by subtype. In 1994, a cohort of women was identified in Ireland as having been iatrogenically exposed to the hepatitis C virus. The women were all young and exposed as a consequence of the receipt of HCV 1b contaminated anti-D immunoglobulin. The source of the infection was identified as an acutely infected female. As part of a voluntary serological screening programme involving 62,667 people, 704 individuals were identified as seropositive for exposure to the hepatitis C virus; 55.4% were found to be positive for the viral genome 17 years after exposure. Of these women 98% had evidence of inflammation, but suprisingly, a remarkable 49% showed no evidence of fibrosis. Clinicopathology and virological analysis has identified associations between viral load and the histological activity index for inflammation, and, between inflammation and levels of the liver enzyme alanine aminotransferase. Infection at a younger age appears to protect individuals from progression to advanced liver disease. Molecular analyses of host immunogenetic elements shows that particular class II human leukocyte associated antigen alleles are associated with clearance of the hepatitis C virus. Additional class II alleles have been identified that are associated with stable viraemia over an extended period of patient follow-up. Although, investigation of large untreated homogeneous cohorts is likely to become more difficult, as the efficacy of anti-viral therapy improves, further investigation of host and viral factors that influence disease progression will help provide an evidence based approach were realistic expectations regarding patient prognosis can be ascertained. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Spandidos Publications en
dc.subject Hepatitis C en
dc.subject Anti-D immunoglobulin en
dc.subject Chronic liver disease en
dc.subject Sensitivity determining region en
dc.subject Viral load en
dc.subject RNA en
dc.subject Viremia en
dc.subject Ireland en
dc.title The Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (Review) en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Liam J. Fanning, Medicine Department, University College Cork, Cork, Ireland. +353-21-490-3000 Email: l.fanning@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2013-01-21T10:55:01Z
dc.description.version Published Version en
dc.internal.rssid 43338260
dc.internal.wokid 000173412700013
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Molecular Medicine en
dc.internal.copyrightchecked No.!!CORA!! Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress l.fanning@ucc.ie en


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