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Nat Rev Dis Primers. 2017 Mar 2;3:17006. doi: 10.1038/nrdp.2017.6.

Hepatitis C virus infection.

Author information

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Germany.
Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
Liver Unit, Hospital Universitari Vall d'Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Spain.
New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand.
National Reference Center for Viral Hepatitis B, C and D, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France.
INSERM U955, Créteil, France.
Center for Disease Analysis, Lafayette, Colorado, USA.
Viral Hepatitis Center, Division of Gastroenterology, University of California at San Francisco, San Francisco, California, USA.
Beatty Center for Integrated Research, Falls Church, Virginia, USA.


Hepatitis C virus (HCV) is a hepatotropic RNA virus that causes progressive liver damage, which might result in liver cirrhosis and hepatocellular carcinoma. Globally, between 64 and 103 million people are chronically infected. Major risk factors for this blood-borne virus infection are unsafe injection drug use and unsterile medical procedures (iatrogenic infections) in countries with high HCV prevalence. Diagnostic procedures include serum HCV antibody testing, HCV RNA measurement, viral genotype and subtype determination and, lately, assessment of resistance-associated substitutions. Various direct-acting antiviral agents (DAAs) have become available, which target three proteins involved in crucial steps of the HCV life cycle: the NS3/4A protease, the NS5A protein and the RNA-dependent RNA polymerase NS5B protein. Combination of two or three of these DAAs can cure (defined as a sustained virological response 12 weeks after treatment) HCV infection in >90% of patients, including populations that have been difficult to treat in the past. As long as a prophylactic vaccine is not available, the HCV pandemic has to be controlled by treatment-as-prevention strategies, effective screening programmes and global access to treatment.

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