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Hepatitis C

Hepatitis C virus (HCV) is an RNA virus that is classified into the family Flaviviridae. HCV is most frequently transmitted by blood and blood derivatives. Sexual transmission of HCV has also been described. The World Health Organization estimates that 1% of the population worldwide carries HCV infection. The prevalence of HCV infection in Europe ranges between 0.5-2.0% but in some regions of Africa it exceeds 4% (in Egypt around 5% of the general population is infected). According to the local epidemiological estimates, around 39 500 persons in Croatia are likely to be infected with HCV (Kaić et al, 2013).

Acute HCV infection remains most often undiagnosed and infection is usually detected later, at the chronic stage of infection. The majority of individuals are diagnosed with chronic hepatitis C due to random detection of elevated liver enzyme values during diagnostic workup of other diseases or following clinical presentation of liver disease. Chronic HCV infection is associated with significant morbidity and mortality, possible development of cirrhosis (in 20% of chronically infected persons during the period between 10-30 years) and hepatocellular carcinoma (1-5% of patients with cirrhosis annually) as well as liver transplantation in patients with end-stage liver disease (Kurelac et al, 2013).

HCV vaccine is not available. However, chronic hepatitis C can be successfully treated in a majority of patients with new generation of direct acting antiviral drugs (DAA) that disrupt the activity of enzymes responsible for HCV replication. Due to the fact that HCV genome does not integrate into the genome of the host cell, complete eradication of HCV RNA by DAA treatment is possible. Eradication of the virus prevents the progression of liver disease.

Immunopathogenesis of chronic hepatitis C

HCV infection of hepatocytes (liver cells) is associated with chronic inflammation leading to the progressive damage of the liver, fibrosis and cirrhosis. The aim of the chronic hepatitis C Work package in the Center of Excellence is the analysis of molecular mechanisms of liver inflammation focusing on the role of non-parenchymal liver cells in the immunopathogenesis of chronic hepatitis C by using systems biology approach.