Hepatitis C Virus Infection
Hepatitis C virus (HCV) is an RNA virus causing major worldwide morbidity and mortality. If not diagnosed and treated early, HCV can have severe complications, including esophageal varices, liver cirrhosis with decompensation, and hepatocellular carcinoma. It is the leading indication for liver transplantation and a leading cause of hepatocellular carcinoma in the United States.
Since the discovery of HCV in 1989, remarkable progress has been made in its treatment. The newly approved direct-acting antiviral (DAA) protease inhibitor-based regimen has improved response rates, ushering in a new era in the management of patients with HCV. More effective, short course, and simpler regimens are expected in the near future. The recent update in the screening guidelines published by the US Preventive Services Task Force (USPSTF) is expected to increase the number of patients seeking care.
Epidemiology of HCV
HCV infects 170-200 million people around the globe, accounting for 3% of world's population. It is a much bigger problem compared with HIV, which has an overall prevalence of only about 34 million. In United States, approximately 3.2 million people are infected with HCV, and about two thirds are unaware of their diagnosis.
HCV is the most common chronic bloodborne pathogen in the United States. HCV antibody prevalence approaches 1.6%, and 78% of persons who test positive have detectable viremia.
Currently, 6 major genotypes and more than 80 subtypes have been identified worldwide. Genotype 1 is the most common type in the United States, where an estimated 16,000 new cases of HCV and 15,000 HCV-related deaths occur yearly.