Acute Hepatitis C Virus Infection: A Dynamic—and Challenging—Concept

Worldwide, 170–200 million individuals are infected with hepatitis C virus (HCV). Chronic infection, which arises in the majority of infected individuals, predisposes to the development of cirrhosis and hepatocellular carcinoma, with attendant life-threatening complications. The HCV pandemic constitutes a significant global health and economic burden, and further spread of infection, in the absence of effective preventive measures, will maintain this burden for some time to come. Diagnosis and management of chronic HCV infection have improved significantly in the past 20 years. Third-generation enzyme immunoassays, combination tests that are able to detect both anti-HCV antibodies and HCV core antigen, and the development of real-time nucleic acid amplification techniques have all contributed to an effective armory of highly sensitive and specific diagnostic tests. Response rates to therapy have improved from a paltry 10% for interferon monotherapy to >50% for pegylated interferon plus ribavirin combination therapy, with the imminent prospect of even better results with the advent of specifically targeted antiviral therapy againstHCV[1].