van Hattum J
Academisch Ziekenhuis, afd. Gastro-enterologie, Utrecht.
Ned Tijdschr Geneeskd. 1996 Jan 20;140(3):119-24.
Cloning of the hepatitis C virus (HCV) was reported in 1989. By now, the entire viral genome has been sequence. It consists of a single-stranded positive RNA, with relationship to the Flaviviridae. The envelope region shows considerable variability. 6 major genotypes have been described. HCV is transmitted via the parenteral route, mainly blood, rarely by sexual contact. Hepatitis C occurs worldwide and is found in 0.01 to 1.5% of blood donors. The immune response is unable to clear the virus in 80% of infected subjects, probably because of the hypervariability. In the acute phase the hepatitis has only mild symptoms and the chronic hepatitis usually also runs a mild course. After many years liver cirrhosis may develop in 20% of cases; in these subjects there is a high incidence of hepatocellular carcinoma. The diagnosis can be made by detection of anti-HCV antibodies in the blood and an immunoblot confirmation test. The viral genome can be detected by the HCV-RNA (PCR) test. Immunisation against hepatitis C is not possible yet. Therapy with interferon results in an initial response in 45% and a sustained response in < 20% of the patients. Interferon therapy reduces the incidence of hepatocellular carcinoma.
丙型肝炎病毒（HCV）于1989年被报道克隆成功。到目前为止，其整个病毒基因组已被测序。它由单链正链RNA组成，与黄病毒科有关。包膜区域显示出相当大的变异性。已描述了6种主要基因型。HCV通过肠道外途径传播，主要是血液传播，很少通过性接触传播。丙型肝炎在全球范围内都有发生，在0.01%至1.5%的献血者中被发现。80%的受感染个体的免疫反应无法清除病毒，这可能是由于其高度变异性。在急性期，肝炎只有轻微症状，慢性肝炎通常也病程较轻。多年后，20%的病例可能会发展为肝硬化；在这些患者中，肝细胞癌的发病率很高。诊断可通过检测血液中的抗HCV抗体和免疫印迹确认试验来进行。病毒基因组可通过HCV-RNA（PCR）检测来检测。目前还无法进行丙型肝炎免疫接种。干扰素治疗使45%的患者产生初始反应，<20%的患者产生持续反应。干扰素治疗可降低肝细胞癌的发病率。
