Molecular and Contextual Markers of Hepatitis C Virus and Drug Abuse

Abstract

The spread of hepatitis C virus (HCV) infection involves a complex interplay of social risks, and molecular factors of both virus and host. Injection drug abuse is the most powerful risk factor for HCV infection, followed by sexual transmission and additional non-injection drug abuse factors such as co-infection with other viruses and barriers to treatment. It is clearly important to understand the wider context in which the factors related to HCV infection occur. This understanding is required for a comprehensive approach leading to the successful prevention, diagnosis, and treatment of HCV. An additional consideration is that current treatments and advanced molecular methods are generally unavailable to socially disadvantaged patients. Thus, the recognition of behavioral/social, viral, and host factors as components of an integrated approach to HCV is important to help this vulnerable group. Equally important, this approach is key to the development of personalized patient treatment – a significant goal in global healthcare. In this review, we discuss recent findings concerning the impact of drug abuse, epidemiology, social behavior, virology, immunopathology, and genetics on HCV infection and the course of disease.

Estimated prevalence of Hepatitis C Virus infection in Canada, 2011

“…Approximately three out of four persons with acute HCV infection will not clear the virus spontaneously within six months and will develop chronic HCV infection with an array of long-term sequelae (2). The diagnosis of HCV infection is usually based on identifying antibodies to HCV (anti-HCV) and/or the viral material (i.e., HCV ribonucleic acid) (3) alongside certain liver function enzyme tests (4). A positive anti-HCV test result indicates past or current HCV infection since the HCV antibodies may remain after the virus has cleared.…”

Inactivation and Survival of Hepatitis C Virus on Inanimate Surfaces

“…Furthermore, crosscontamination continues to occur among injection drug users (IDUs) by the sharing of drug preparation equipment [16][17][18]. The seroprevalence of HCV among IDUs in the United States is high, ranging between 30% and 85%, with current estimates suggesting more than over 60% of newly acquired infections occur in individuals who have injected drugs [19,20]. The adequate assessment of transmission risks and the evaluation of the mechanisms of transmission have been difficult due to the lack of cell culture systems and animal models permissive to HCV infection.…”