Hepatitis C : A Brief Clinical Overview

Abstract

Hepatitis C has emerged as an important public health problem that has affected 3.9 million Americans and 170 million people worldwide and is currently the most common indication for orthotopic liver transplantation. The disease, characterized by asymptomatic onset, is often discovered incidentally through blood tests obtained during routine physical examination or before blood donation. Spontaneous recovery occurs in about 20% of patients. Among those who remain chronically infected, an equal percentage progress to cirrhosis within 20 yr, have stable nonprogressive disease, or progress more slowly over 40 to 60 yr. At present, combination therapy with interferon plus ribavirin is the treatment of choice for hepatitis C-infected patients identified as appropriate candidates for therapy. Unfortunately, sustained response rates are only modest, with a lesser response among African Americans, and treatment is associated with a number of side effects. Research studies attempting to improve the response to current therapy, to identify alternative treatments or treatment strategies, and to develop an effective vaccine are ongoing and will hopefully provide us with the ability to better understand and manage hepatitis C.

CD81-Dependent Binding of Hepatitis C Virus E1E2 Heterodimers

“…It is a major cause of chronic hepatitis, liver cirrhosis, hepatocellular carcinoma (53), and mixed cryoglobulinemia, a B-lymphocyte proliferative disorder (reviewed in references 6 and 49). HCV is a small enveloped virus that belongs to the Hepacivirus genus in the Flaviviridae family (33).…”

Inhibitors of HCV NS5B polymerase. Part 2: Evaluation of the northern region of (2Z)-2-benzoylamino-3-(4-phenoxy-phenyl)-acrylic acid

“…Overall, analogs of this type proved less potent than their benzamide counterparts. Examining the phenyl acetyl compounds (n = 1, 37-41) revealed that substitution at the R 3 position with halogens provided optimal relative activity (i.e., compounds 37-39); however, these compounds were approximately 10-fold less active than the simple unsubstituted benzamide (2). Similarly, for phenyl ethyl amide compounds (n = 2, 42-45) substitution of the R 3 position with CF 3 , Cl, and F provided optimal relative activity, but overall analogs of this type also had lower potency than benzamide 2.…”

“…Chronic HCV infections have been associated with liver fibrosis, liver cirrhosis, heptacellular carcinoma, and other forms of liver dysfunction. 1,2 Given the wide spread impact of this disease, there is a substantial medical need for new anti-HCV agents to compliment current therapies. In this and the preceding article, we report on our efforts to develop orally bioavailable, non-nucleoside inhibitors of HCV NS5B RNA-dependent RNA polymerase.…”

Assessment of the Response to Treatment in Patients with the Hepatitis C Virus Infection: A Quantitative Study by Focusing on Virologic and Biochemical Responses

“…Also, liver biopsy is the most reliable method used to determine the extent of liver damage and fibrosis (4). Regarding the disease progression, the disease in its acute phase can be recovered spontaneously in 20% of cases, but 70% -80% of cases can continue as the chronic phase to be a cause varying degrees of liver inflammation, fibrosis or even cirrhosis (5). In less than 5% of the affected ones, this infection progression may lead to hepatocellular carcinoma (6).…”