The Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (review).

Hdl Handle:
http://hdl.handle.net/10147/209053
Title:
The Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (review).
Authors:
Fanning, Liam J
Affiliation:
Hepatitis C Unit, Department of Medicine, Clinical Sciences Building, National, University of Ireland, Cork, Cork University Hospital, Cork, Ireland., lfanning@ucc.ie
Citation:
Int J Mol Med. 2002 Feb;9(2):179-84.
Journal:
International journal of molecular medicine
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209053
PubMed ID:
11786930
Abstract:
The aetiological agent of chronic hepatitis C is the hepatitis C virus. The hepatitis C virus is spread by parenteral transmission of body fluids, primarily blood or blood products. In 1989, after more than a decade of research, HCV was isolated and characterised. The hepatitis C viral genome is a positive-sense, single-stranded RNA molecule approximately 9.4 kb in length, which encodes a polyprotein of about 3100 amino acids. There are 6 main genotypes of HCV, each further stratified by subtype. In 1994, a cohort of women was identified in Ireland as having been iatrogenically exposed to the hepatitis C virus. The women were all young and exposed as a consequence of the receipt of HCV 1b contaminated anti-D immunoglobulin. The source of the infection was identified as an acutely infected female. As part of a voluntary serological screening programme involving 62,667 people, 704 individuals were identified as seropositive for exposure to the hepatitis C virus; 55.4% were found to be positive for the viral genome 17 years after exposure. Of these women 98% had evidence of inflammation, but surprisingly, a remarkable 49% showed no evidence of fibrosis. Clinicopathology and virological analysis has identified associations between viral load and the histological activity index for inflammation, and, between inflammation and levels of the liver enzyme alanine aminotransferase. Infection at a younger age appears to protect individuals from progression to advanced liver disease. Molecular analyses of host immunogenetic elements shows that particular class II human leukocyte associated antigen alleles are associated with clearance of the hepatitis C virus. Additional class II alleles have been identified that are associated with stable viraemia over an extended period of patient follow-up. Although, investigation of large untreated homogeneous cohorts is likely to become more difficult, as the efficacy of anti-viral therapy improves, further investigation of host and viral factors that influence disease progression will help provide an evidence based approach were realistic expectations regarding patient prognosis can be ascertained.
Language:
eng
MeSH:
Ethnic Groups; Female; Hepatitis C, Chronic/*epidemiology/*virology; Host-Parasite Interactions/physiology; Humans; Ireland/epidemiology; Male
ISSN:
1107-3756 (Print); 1107-3756 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorFanning, Liam Jen_GB
dc.date.accessioned2012-02-03T15:10:59Z-
dc.date.available2012-02-03T15:10:59Z-
dc.date.issued2012-02-03T15:10:59Z-
dc.identifier.citationInt J Mol Med. 2002 Feb;9(2):179-84.en_GB
dc.identifier.issn1107-3756 (Print)en_GB
dc.identifier.issn1107-3756 (Linking)en_GB
dc.identifier.pmid11786930en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209053-
dc.description.abstractThe aetiological agent of chronic hepatitis C is the hepatitis C virus. The hepatitis C virus is spread by parenteral transmission of body fluids, primarily blood or blood products. In 1989, after more than a decade of research, HCV was isolated and characterised. The hepatitis C viral genome is a positive-sense, single-stranded RNA molecule approximately 9.4 kb in length, which encodes a polyprotein of about 3100 amino acids. There are 6 main genotypes of HCV, each further stratified by subtype. In 1994, a cohort of women was identified in Ireland as having been iatrogenically exposed to the hepatitis C virus. The women were all young and exposed as a consequence of the receipt of HCV 1b contaminated anti-D immunoglobulin. The source of the infection was identified as an acutely infected female. As part of a voluntary serological screening programme involving 62,667 people, 704 individuals were identified as seropositive for exposure to the hepatitis C virus; 55.4% were found to be positive for the viral genome 17 years after exposure. Of these women 98% had evidence of inflammation, but surprisingly, a remarkable 49% showed no evidence of fibrosis. Clinicopathology and virological analysis has identified associations between viral load and the histological activity index for inflammation, and, between inflammation and levels of the liver enzyme alanine aminotransferase. Infection at a younger age appears to protect individuals from progression to advanced liver disease. Molecular analyses of host immunogenetic elements shows that particular class II human leukocyte associated antigen alleles are associated with clearance of the hepatitis C virus. Additional class II alleles have been identified that are associated with stable viraemia over an extended period of patient follow-up. Although, investigation of large untreated homogeneous cohorts is likely to become more difficult, as the efficacy of anti-viral therapy improves, further investigation of host and viral factors that influence disease progression will help provide an evidence based approach were realistic expectations regarding patient prognosis can be ascertained.en_GB
dc.language.isoengen_GB
dc.subject.meshEthnic Groupsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHepatitis C, Chronic/*epidemiology/*virologyen_GB
dc.subject.meshHost-Parasite Interactions/physiologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.titleThe Irish paradigm on the natural progression of hepatitis C virus infection: an investigation in a homogeneous patient population infected with HCV 1b (review).en_GB
dc.contributor.departmentHepatitis C Unit, Department of Medicine, Clinical Sciences Building, National, University of Ireland, Cork, Cork University Hospital, Cork, Ireland., lfanning@ucc.ieen_GB
dc.identifier.journalInternational journal of molecular medicineen_GB
dc.description.provinceMunster-

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