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

dc.contributor.authorFanning, Liam J.
dc.date.accessioned2016-06-17T14:28:47Z
dc.date.available2016-06-17T14:28:47Z
dc.date.issued2002-02-01
dc.date.updated2013-01-21T10:55:01Z
dc.description.abstractThe 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFanning, 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.9.2.179en
dc.identifier.doi10.3892/ijmm.9.2.179
dc.identifier.endpage184en
dc.identifier.issn1107-3756
dc.identifier.issn1791-244X
dc.identifier.journaltitleInternational Journal of Molecular Medicineen
dc.identifier.startpage179en
dc.identifier.urihttps://hdl.handle.net/10468/2756
dc.identifier.volume9en
dc.language.isoenen
dc.publisherSpandidos Publicationsen
dc.subjectHepatitis Cen
dc.subjectAnti-D immunoglobulinen
dc.subjectChronic liver diseaseen
dc.subjectSensitivity determining regionen
dc.subjectViral loaden
dc.subjectRNAen
dc.subjectViremiaen
dc.subjectIrelanden
dc.titleThe 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.typeArticle (peer-reviewed)en
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