HEPATITIS-C - NATURAL-HISTORY OF A UNIQUE INFECTION

In 1988 investigators defined the agent causing most cases of non-A, n on-B hepatitis and named this agent hepatitis C virus (HCV), Assays fo r antibody to HCV and more specific diagnostic tests (immunoblot and p olymerase chain reactions) were subsequently developed, Exposure to HC V seems to result in chronic infection in a majority of cases, with pr ogressive chronic liver disease sometimes leading to hepatocellular ca rcinoma, This virus is spread mainly by parenteral routes; intravenous drug users are at high risk, Sexual and intrafamilial spread has also been documented but seems to occur to a limited extent, Perinatal tra nsmission, which is prominent in infection with hepatitis B virus, doe s not play an important role in the spread of HCV, Antiviral therapy w ith interferon cu is usually tried in chronic hepatitis C but permanen tly normalizes liver function in only one-fourth of patients, The fail ure to demonstrate protective immunity after single or multiple episod es of infection raises doubts about the existence of neutralizing anti bodies and concerns about the potential for the development of a vacci ne against HCV.