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Chronic Hepatitis C: the hope for a cure
Merican, I1.
Chronic hepatitis C (CHC) is a major public health problem and is an important cause of preventable death and morbidity from chronic liver disease. In Malaysia, the incidence rate of CHC is 6.8/100,000 population in 20134. It is anticipated that an increasing number of people are likely to die from HCV-related liver cirrhosis, liver failure or liver cancer over the next 2 decades. Most patients with CHC are asymptomatic. 55-85% of patients with CHC will progress to chronic liver disease if left untreated. 15-30% of these patients will develop cirrhosis within 20 years and 2-4 % will die of liver cancer7-10. As most patients are unaware of their infection status, there is an urgent need to screen patients especially those at risk such as those who have received blood transfusions, tissue and organ transplantation before the introduction of routine blood screening in 1995, intravenous drug users, those with HIV infection, health care workers, current sexual partners of HCV-infected persons and patients on haemodialysis. Although there is no vaccine currently available for hepatitis C, there is still hope for a cure with the recent breakthrough discovery of new drugs that can provide a cure for patients with chronic hepatitis C. HCV is a positive-stranded RNA-enveloped virus belonging to the Flaviviridae family. The HCV genome was identified and cloned in 198911. HCV circulates as a heterogeneous population or quasispecies which differ in nucleotide sequence by 1-5%. HCV undergoes rapid mutation in a hypervariable region of the genome coding for the envelope proteins and escapes immune surveillance by the host, which helps explain the development of chronic infection in HVC-infected patients12. HCV genotyping should be performed in all HCV-infected persons prior to treatment to establish the dose and duration of therapy and estimate the likelihood of response to treatment.
Affiliation:
- Mahsa University College, Malaysia
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