[Hepatitis C virus].

Abstract

Hepatitis C virus is a major cause of liver disease worldwide. It is estimated that globally 170 million people are affected. Infection is parenteral. In many countries most recent acquisition is in people who inject drugs, but transmission worldwide also occurs in in healthcare settings due to the reuse or inadequate sterilization of medical equipment and the transfusion of unscreened blood and blood products. Sexual transmission also occurs, particularly in men who have sex with men. The virus has a tendency to become persistent in most of those infected. However, a substantial minority (around 25%) do clear the virus as a result of effective innate and adaptive immune responses at the times of acute infection. In those with persistent infection, the clinical course is quite variable. Treatment with directly acting antiviral drugs is well tolerated and leads to very high cure rates in chronic disease.