Hepatitis C virus infection in 2012 and beyond

Abstract

Hepatitis C virus infection is estimated to affect 150 million people worldwide. A large number of individuals are chronically infected and are at risk of developing chronic liver disease, cirrhosis and hepatocellular carcinoma. Chronic hepatitis C infection causes signifcant morbidity and mortality. It is the leading indication for liver transplantation in the USA and Europe, and accounts for 30-50% of liver transplants in those countries. The introduction of blood and blood product screening protocols in 1992 led to a decline in new infections, but intravenous drug abuse still remains a major risk factor for acquiring the disease. Since no vaccine is available to prevent infection with this virus, research has been ongoing to fnd a cure. Treatment of hepatitis C has continuously evolved since the introduction of interferon monotherapy in the early 1990s, with very low response rates. In 2002, the use of pegylated interferon and ribavirin signifcantly improved sustained virological response rates to 50-80%. The management of patients who do not respond to standard care remains challenging. The US FDA approved directly acting antivirals in May 2011. This introduced a new era with regard to management of this condition.