Genotypes 1a and 1b are prevalent in the United States, whereas in other countries, genotype 1a is less frequent.Genotype details are as follows: Transfusion of blood contaminated with hepatitis C virus (HCV) was once a leading means of HCV transmission.
NS5A is critical for the assembly of the cytoplasmic membrane-bound replication complex; one region within NS5A is linked to an interferon (IFN) response and is called the IFN sensitivity–determining region.
NS5B is an RNA dependent RNA polymerase required for viral replication; it lacks proofreading capabilities and generates a large number of mutant viruses known as quasispecies.
HCV genomic analysis by means of an arduous gene sequencing of many viruses has led to the division of HCV into six genotypes based on homology. Arabic numerals denote the genotype, and lower-case letters denote the subtypes for lesser homology within each genotype.
Molecular differences between genotypes are relatively large, and they have a difference of at least 30% at the nucleotide level.
The natural targets of HCV are hepatocytes and, possibly, B lymphocytes.
Viral clearance is associated with the development and persistence of strong virus-specific responses by cytotoxic T lymphocytes and helper T cells.
In the United States, the incidence of acute HCV infection has sharply decreased during the past decade, but its prevalence remains high.
According to US Centers for Disease Control and Prevention (CDC) estimates, 2.7-3.9 million people (most of whom were born from 1945 through 1965) in the United States have chronic hepatitis C which develops in approximately 75% of patients after acute a leading cause of morbidity and mortality, primarily through the development of liver fibrosis and cirrhosis; persons with chronic infection live an average of 2 decades less than healthy persons.
The prevalence of HCV infection varies throughout the world.
For example, Frank et al reported in 2000 that Egypt had the highest number of reported infections, largely attributed to the use of contaminated parenteral antischistosomal therapy.
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