Czepiel Jacek, Biesiada Grazyna, Mach Tomasz
Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland.
Pol Arch Med Wewn. 2008 Dec;118(12):734-40.
Hepatitis C is caused by the hepatitis C virus (HCV) infection. According to World Health Organization data, 3% of the world population (approximately 170 million people) is infected with HCV; in Poland there are over 700,000. Over 70% of those infected manifest no symptoms in the acute phase of the disease, and in about 70-80% the acute phase progresses into a chronic form. Patients with symptoms in the acute phase of HCV infection most commonly present with unspecific signs and symptoms that may develop in other viral liver infections, e.g. malaise, fatigue, abdominal pain, mild hepato- and splenomegaly and arthralgia. These symptoms usually persist for 2 to 12 weeks. In the chronic phase a subset of patients complain of malaise, nausea, abdominal pain and itching. With time, chronic hepatitis C may develop into liver cirrhosis. The basic diagnostic methods in HCV infection involve determination of anti-HCV antibodies using the ELISA immunoassay and examination of HCV-RNA with the RT-PCR method. The current treatment of HCV infection involves administration of pegylated interferon a and ribavirin over a period of 48 weeks in HCV-1 genotype infection, and 24 weeks for HCV-2 and 3 genotypes. Effectiveness of therapy depends on the HCV genotype. HCV elimination can be achieved in 78% of patients with HCV-2 and 3 genotypes, and in 55% of patients with HCV-1 genotype.
丙型肝炎由丙型肝炎病毒（HCV）感染引起。根据世界卫生组织的数据，全球3%的人口（约1.7亿人）感染了HCV；在波兰，感染人数超过70万。超过70%的感染者在疾病急性期没有症状，约70 - 80%的急性期会发展为慢性形式。HCV感染急性期有症状的患者最常见的是非特异性体征和症状，这些症状也可能出现在其他病毒性肝脏感染中，如不适、乏力、腹痛、轻度肝脾肿大和关节痛。这些症状通常持续2至12周。在慢性期，一部分患者会抱怨不适、恶心、腹痛和瘙痒。随着时间的推移，慢性丙型肝炎可能发展为肝硬化。HCV感染的基本诊断方法包括使用ELISA免疫测定法检测抗HCV抗体以及用RT-PCR方法检测HCV-RNA。目前HCV感染的治疗方法是，对于HCV-1基因型感染，给予聚乙二醇化干扰素α和利巴韦林治疗48周，对于HCV-2和3基因型则治疗24周。治疗效果取决于HCV基因型。HCV-2和3基因型患者中有78%可以实现病毒清除，HCV-1基因型患者中有55%可以实现病毒清除。
