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DESCARTES BEFORE THE HORSE - I CLONE, THEREFORE I AM - THE HEPATITIS-C VIRUS IN CURRENT PERSPECTIVE
Author(s): ALTER HJ
Source: ANNALS OF INTERNAL MEDICINE    Volume: 115    Issue: 8    Pages: 644-649    Published: OCT 15 1991  
Times Cited: 102     References: 29     
Abstract: In an unprecedented approach to viral discovery, the hepatitis C virus (HCV) was cloned before it was established by conventional methods of viral detection or by genomic characterization. Hepatitis C virus is a small (10-kb), single-stranded RNA virus with a genomic organization that places it in the family Flaviviridae. The virus is global in distribution, with a prevalence between 0.3% and 1.5%. The same agent causes parenterally acquired and sporadic non-A, non-B hepatitis. Nonparenteral modes of spread are poorly defined, but low-level sexual transmission is probable. There is a strong association between the presence of antibody to HCV (anti-HCV) and hepatocellular carcinoma; a causal role for HCV is suspected but has not been proved.

Hepatitis C virus accounts for at least 85% of the cases of transfusion-associated hepatitis; an anti-HCV-reactive donor was retrospectively identified in nearly 90% of cases. Among donors confirmed by recombinant immunoblot assay (RIBA) to be anti-HCV positive, 80% to 90% are infectious. Hepatitis C virus RNA can be detected within 1 to 2 weeks of exposure and persists throughout the course of infection. Generally, the presence of anti-HCV cannot be confirmed until 9 to 20 weeks after exposure, creating a window period of seronegativity and potential infectivity. It is anticipated that the anti-HCV assay will reduce the number of cases of transfusion-associated hepatitis by 50% in the United States; a 70% reduction has been documented in Spain.

Document Type: Article
Language: English
Reprint Address: ALTER, HJ (reprint author), NIH, IMMUNOL SECT, 9000 ROCKVILLE PIKE, BLDG 10, ROOM 1C711, BETHESDA, MD 20892 USA
Addresses:
1. NIH, DEPT TRANSFUS MED, BETHESDA, MD 20892 USA
Publisher: AMER COLL PHYSICIANS, INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572
Subject Category: Medicine, General & Internal
IDS Number: GJ902
ISSN: 0003-4819
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