Valladares Alvarez Guillermo
Secretario General de la Asociación Peruana para el estudio del Hígado Unidad de Hígado del Policlínico Peruano - Japonés.
Rev Gastroenterol Peru. 2003 Apr-Jun;23(2):126-33.
The Hepatitis C virus has emerged over the last two decades as the cause of the second greatest viral infection epidemic after the human immunodeficiency virus (HIV). A significant characteristic of the infection with the Hepatitis C virus is the variable course of its natural history. About 80% of the people who acquire this agent develop a chronic infection, with varying degree of liver damage, including cirrhosis and even hepatocelular carcinoma. However, only a minority progresses towards more severe forms. Several factors associated with the host seem to influence the progression of Hepatitis C into cirrhosis. The most important are alcohol abuse, the age in which the infection is acquired, duration of the infection, overweight, male sex and coinfection with Hepatitis A or B or HIV. Evidence of the role of iron levels in the liver, tobacco or the source of infection are less clear. The factors associated with the agent do not seem to play any role in the progression of the disease. Additional studies with adequate control groups are required to confirm the participation of the above mentioned host factors and to identify others which could influence the natural history of the Hepatitis C infection. A reduction in the ingestion of alcohol, overweight and tobacco consumption could contribute to the treatment of HVC chronic infection, as well as vaccination against Hepatitis A and B.
在过去二十年中，丙型肝炎病毒已成为仅次于人类免疫缺陷病毒（HIV）的第二大病毒性感染流行病因。丙型肝炎病毒感染的一个显著特征是其自然史进程多变。约80%感染该病原体的人会发展为慢性感染，伴有不同程度的肝损伤，包括肝硬化甚至肝细胞癌。然而，只有少数人会进展为更严重的形式。一些与宿主相关的因素似乎会影响丙型肝炎发展为肝硬化的进程。其中最重要的是酗酒、感染时的年龄、感染持续时间、超重、男性以及与甲型或乙型肝炎或HIV合并感染。肝脏铁水平、烟草或感染源所起作用的证据尚不太明确。与病原体相关的因素似乎在疾病进展中不起任何作用。需要进行有适当对照组的进一步研究，以证实上述宿主因素的参与情况，并确定其他可能影响丙型肝炎感染自然史的因素。减少酒精摄入、超重和烟草消费，以及接种甲型和乙型肝炎疫苗，可能有助于丙型肝炎慢性感染的治疗。
