Hepatitis C: Update 2000

Abstract

With the discovery of the nucleotide sequence of the HCV genom it was possible to develop virological and serological testsystems for the diagnosis of HCV infections. The presence of HCV antibodies indicates that the virus is also present. More than 90% of the infected persons develop a chronic infection. This leads in 20% of the virus carriers to the development of cirrhosis after 20 years. About 20% to 40% of the virus carriers never develop a clinical disease. In 70% new infections are mainly transmitted by intravenous drug abuse. The combination therapy with pegulated Interferon-α and Ribavirin can at present be considered as the standard therapy. The chance of a sustained response is in the case of the genotypes 1a and 1b about 35% and in the case of the genotypes 2 and 3a about 40% to 60%. In spite the progress made the therapeutic possibilities do not satisfy yet. The development of new drugs is urgently needed. In the coming years a sharp increase in the numbers of cases with cirrhosis and of hepatocellular carcinomas due to the HCV is to be expected.