Department of Pathology, Saint Louis University, Saint Louis, MO.
Department of Internal Medicine, Saint Louis University, Saint Louis, MO.
Hepatology. 2019 Feb;69(2):889-900. doi: 10.1002/hep.30214.
Chronic hepatitis C virus (HCV) infection-associated liver disease is a global health problem. HCV often causes silent disease, and eventually progresses to end-stage liver disease. HCV infects hepatocytes; however, initial manifestation of liver disease is mostly displayed in hepatic stellate cells (HSCs), causing fibrosis/cirrhosis, and is believed to occur from inflammation in the liver. It remains unclear why HCV is not spontaneously cleared from infected liver in the majority of individuals and develops chronic infection with progressive liver disease. Direct-acting antivirals (DAAs) show excellent results in controlling viremia, although beneficial consequence in advanced liver disease remains to be understood. In this review, we highlight the current knowledge that has contributed to our understanding of the role of HCV in inflammation, immune evasion, metabolic disorders, liver pathogeneses, and efforts in vaccine development.
慢性丙型肝炎病毒(HCV)感染相关肝病是一个全球性的健康问题。HCV 通常导致无症状疾病,最终进展为终末期肝病。HCV 感染肝细胞;然而,肝病的最初表现主要在肝星状细胞(HSCs)中显现,导致纤维化/肝硬化,据信这是由肝脏炎症引起的。目前尚不清楚为什么 HCV 在大多数感染者的感染肝脏中不能被自发清除,而是发展为慢性感染和进行性肝病。直接作用抗病毒药物(DAAs)在控制病毒血症方面显示出极佳的效果,尽管其对晚期肝病的有益作用仍有待了解。在这篇综述中,我们强调了目前有助于我们理解 HCV 在炎症、免疫逃逸、代谢紊乱、肝脏发病机制以及疫苗开发方面的作用的知识。