CURRENT STATUS OF THE MOLECULAR-GENETICS OF HEPATITIS-C VIRUS AND ITSUTILIZATION IN THE DIAGNOSIS OF INFECTION

Background: Since the discovery of hepatitis C virus (HCV) as a major cause of non-A non-B hepatitis, advances have been made in our underst anding of the molecular biology of HCV and its relatedness to the flav iviruses and pestiviruses. The use of molecular techniques to construc t an antibody assay has enabled the accumulation of information concer ning the natural history and pathogenesis of HCV infection. Objectives : The objective was to review the literature to March 1994 on the stru cture, function and genetics of HCV and to correlate these findings wi th approaches to diagnosis that have contributed to our understanding Of HCV infections. Study design: We reviewed the virological and medic al literature from 1988 to March of 1994 with a focus on the stated ob jectives. Results: Although the structure of HCV has been well-defined , our knowledge of the function of all the genes of HCV is incomplete. Structural core and envelope proteins as well as enzymes have been de scribed. The 5' end of the polypeptide is most conserved. Genotyping o f isolates varies according to the part of the gene examined. Several genotypes exist and tend to predominate in global populations. Antibod ies to the various proteins can be measured by EIA assays and positive specimens often require confirmatory testing. Uniquely sensitive nucl eic acid detection systems for RNA amplified by PCR have enabled a bet ter understanding of the natural history, epidemiology and responses t o treatment.Conclusions: Well-designed studies for the detection of nu cleic acid, antibodies and antigens using a variety of viral gene prod ucts will provide even more information about HCV infections and help lead to treatment and prevention.