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Nov 24, 2016Article Details
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Main Article Content
Hepatitis C - a South African perspective
Abstract
The existence of non-A, non-B (NANB) hepatitis was established in the 1970s, when accurate serological tests allowed exclusion of hepatitis A and B viruses as the cause of most cases of post-transfusion hepatitis. The term 'hepatitis C' was coined after molecular cloning of nucleic acid from highly infectious sera of chimpanzees identified an RNA virus as the primary cause of post-transfusion hepatitis (PTH). Sequence analysis and expression of the RNA has shown it to be closely related to the flavi- and pestiviruses. It has marked genomic variability which may affect its biological and immunological characteristics, is transmitted parenterally and sporadically, by as yet unidentified routes, and causes chronic indolent liver disease in 50 - 75% of infected patients. It is associated with hepatocellular carcinoma, glomerulonephritis, cryoglobulinaemia, auto-immune liver disease, lymphocytic sialadenitis and porphyria cutanea tarda. Up to 500 million people worldwide may be infected with hepatitis C virus (HCV), and many questions about the disease remain unanswered. Therapy is still largely ineffective and our current understanding of the long-term natural history, our methods of diagnosis, therapy, prevention and immunisation are suboptimal.
