hepatitis C virus enigma

Hepatitis C virus (HCV) has a high propensity to establish chronic infection with end-stage liver disease. The high turnover of virus particles and high transcription error rates due to lack of proof-reading function of the viral polymerase imply that HCV exists as quasispecies, thus enabling the vi...

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Bibliographic Details
Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2009-05, Vol.117 (5-6), p.427-439
Main Authors: MYRMEL, HELGE, ULVESTAD, ELLING, ÅSJØ, BIRGITTA
Format: Article
Language:English
Subjects:
Antigens, CD - physiology
Antiviral Agents - pharmacology
Antiviral Agents - therapeutic use
Biological Evolution
Disease Progression
Drug Synergism
Hepacivirus - drug effects
Hepacivirus - immunology
Hepacivirus - pathogenicity
Hepacivirus - physiology
Hepatitis
Hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - immunology
Hepatitis C, Chronic - virology
Host-Pathogen Interactions - drug effects
Host-Pathogen Interactions - immunology
Humans
immunology
Interferon-alpha - pharmacology
Interferon-alpha - therapeutic use
Liver Cirrhosis - etiology
Liver Neoplasms - etiology
Polyethylene Glycols - pharmacology
Polyethylene Glycols - therapeutic use
Receptors, Virus - physiology
Recombinant Proteins
Ribavirin - pharmacology
Ribavirin - therapeutic use
T-Lymphocyte Subsets - drug effects
T-Lymphocyte Subsets - immunology
Tetraspanin 28
variability
Viral Hepatitis Vaccines
Viremia - immunology
Viremia - virology
virus
Virus Replication
viruses
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Summary:Hepatitis C virus (HCV) has a high propensity to establish chronic infection with end-stage liver disease. The high turnover of virus particles and high transcription error rates due to lack of proof-reading function of the viral polymerase imply that HCV exists as quasispecies, thus enabling the virus to evade the host immune response. Clearance of the virus is characterized by a multispecific, vigorous and persistent T-cell response, whereas T-cell responses are weak, narrow and transient in patients who develop chronic infection. At present, standard treatment is a combination of pegylated interferon-α and ribavirin, with a sustained viral response rate of 40-80%, depending on genotype. The mechanisms for the observed synergistic effects of the two drugs are still not known in detail, but in addition to direct antiviral mechanisms, the immunomodulatory effects of both drugs seem to be important, with a shift from Th2- to Th1-cytokine profiles in successfully treated patients. This article describes virus-host relations in the natural course of HCV infection and during treatment.
ISSN:0903-4641
1600-0463
DOI:10.1111/j.1600-0463.2009.02454.x