Krónikus C hepatitis: virológiai, immunológiai sajátosságok és a terápia kérdései.

Translated title of the contribution: Chronic hepatitis C: virologic and immunologic aspects and questions of therapy

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Abstract

Characteristics of hepatitis C virus (HCV), importance of its genotypes and mutant variants "quasi-species", as well as the mechanisms of disease chronicity and tissue injuries caused by HCV have been discussed. Both a presumed direct cytopathy of the virus and the host's immune response may play a role in the pathogenesis. HCV infects not only hepatocytes but lymphoid cells, thereby modulates immune functions. A molecular minicri--that is a cross-reaction between viral and host antigens--also contributes to autoimmune phenomena developed during chronic HCV infection, in addition a genetic predisposition for autoimmunity can be involved. Until now the only accepted therapy for HCV infection is interferon, that at a standard low dose regimen, results long-term benefit only in one-fourth of treated patients. In Hungary, between 1994-1996 601 chronic hepatitis C patients have been treated: biochemical remission (ALT normalization) was found in 38% of the patients and elimination of the HCV was achieved in 25%. Several questions are to be answered concerning the optimalization of the treatment, e.g. dosage, duration of treatment, re-treatment of relapse, problem of non-responders, the role of predictors of response in the individualized therapy, usefulness of combination treatment. The original end-points and goals of therapy are sustained HCV-RNA negativity, normalization of serum GPT/ALT, and inactivity in liver histology, yet the real end-points are incidence and prevention of cirrhosis and hepatocellular carcinoma, that is the better survival. Concerning these questions, newer therapeutic experiences are discussed, including results from Hungarian researchers.

Translated title of the contributionChronic hepatitis C: virologic and immunologic aspects and questions of therapy
Original languageHungarian
Pages (from-to)1465-1476
Number of pages12
JournalOrvosi hetilap
Volume138
Issue number22 Suppl 1
Publication statusPublished - Jun 1 1997

ASJC Scopus subject areas

  • Medicine(all)

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