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Hepatitis C a
Bharti Mehta , Vijay Kumar Dharma , Sumit Chawla , Harashish Jindal & Bhumika Bhatt
Department of Community Medicine; PGIMS; Rohtak, India Published online: 28 Oct 2013.
Click for updates To cite this article: Bharti Mehta, Vijay Kumar Dharma, Sumit Chawla, Harashish Jindal & Bhumika Bhatt (2014) Hepatitis C, Human Vaccines & Immunotherapeutics, 10:2, 417-419, DOI: 10.4161/hv.26970 To link to this article: http://dx.doi.org/10.4161/hv.26970
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Human Vaccines & Immunotherapeutics 10:2, 417–419; February 2014; © 2014 Landes Bioscience
Hepatitis C Bharti Mehta*, Vijay Kumar, Sumit Chawla, Harashish Jindal, and Bhumika Bhatt Department of Community Medicine; PGIMS; Rohtak, India
Downloaded by [188.8.131.52] at 14:25 26 February 2015
Keywords: hepatitis C, prevention, research, vaccine, virus *Correspondence to: Bharti Mehta; Email: [email protected]
Submitted: 10/17/2013 Accepted: 10/27/2013 Published Online: 10/28/2013 http://dx.doi.org/10.4161/hv.26970
epatitis C Virus (HCV) infection is a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Following acute infection, 20% of people eliminate the virus over weeks or months and are often asymptomatic. The remaining 80% of people will develop chronic disease, of which approximately 20% will eventually develop liver cirrhosis and 1–5% will develop liver cancer. About 150 million people are chronically infected with HCV, and more than 350 000 people die every year from hepatitis C related liver diseases. The economic cost of hepatitis C is significant both to the individual and to the society. In the United States the average lifetime cost of the disease was estimated at $33 407 USD with the cost of a liver transplant approximately $200 000 USD. PEG-IFN and ribavirin treatment is also expensive and, at an average cost of approximately GB £7000 in the UK for a treatment course, is unaffordable in developing countries. Hepatitis C, not only brings down the quality of the life of individuals but also affect progress of the nation by adding financial burden. If we prevent the disease from occurring or find a perfect cure of the disease, in form of a prophylactic or therapeutic vaccine, it will be a boon to not only to the individual but to the nation as a whole.
Introduction Hepatitis C is a transmissible liver disease that results from infection with Hepatitis C Virus (HCV). It has diverse implications ranging from no symptoms
to fatality. It was discovered in the late 1980s but remained in the dark for many years and thought to be of be little importance. In 2010, the World Health Assembly recognized viral hepatitis as a global public health Problem.1 Hence, there is a need for widespread active interventions for its prevention and control. In June 2013, WHO launched the Global Hepatitis Network one of its aims was to support countries with planning and implementation of viral hepatitis plans and programmes. On World Hepatitis Day, WHO urged governments to act against the five hepatitis viruses that can cause severe liver infections and lead to 1.4 million deaths every year.2 The HCV infection is a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma.3,4 Following acute infection, 20% of people eliminate the virus over weeks or months and are often asymptomatic. The remaining 80% of people will develop chronic disease, of which approximately 20% will eventually develop liver cirrhosis and 1–5% will develop liver cancer.5-7 Among those chronically infected, the risk of cirrhosis after 20 y varies between studies but has been estimated at ~10–15% for men and ~1–5% for women. The reason for this difference is not known. Once cirrhosis is established, the rate of developing hepatocellular carcinoma is ~1–4% per year.8 HCV is most commonly transmitted through exposure to infectious blood. This can occur through receipt of contaminated blood transfusions, blood products, and organ transplants; injections given with contaminated syringes
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Is a vaccine the solution?
Global Overview HCV has been shown to have a worldwide distribution, occurring among persons of all ages, genders, races, and regions of the world. About 150 million people are chronically infected with HCV, and more than 350 000 people die every year from hepatitis C related liver diseases.9 Globally the prevalence and number of people with HCV infection has increased from 2.3% to 2.8% and >122 million to >185 million between 1990 and 2005. Central and East Asia and North Africa/Middle East are estimated to have high prevalence (>3.5%); South and Southeast Asia, sub-Saharan Africa, Andean, Central, and Southern Latin America, Caribbean, Oceania, Australia, and Central, Eastern, and Western Europe have moderate prevalence (1.5–3.5%); whereas Asia Pacific, Tropical Latin America, and North America have low prevalence (