What is the pathophysiology of hepatitis C?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Hepatitis C virus is a member of the Flaviviridae family of RNA-containing viruses. Thus, it is not integrated into the host genome.

Although the liver is the primary target of infection, studies to better define the steps of hepatitis C virus infection are greatly hampered by the lack of a suitable animal model for such studies (the only animal known to be susceptible to hepatitis C virus is the chimpanzee). A tissue-culture system using recombinant DNA technology was recently developed and has advanced the scientific knowledge base considerably, including early forays into vaccine development.

The primary immune response to hepatitis C virus is mounted by cytotoxic T lymphocytes. Unfortunately, this process fails to eradicate infection in most people; in fact, it may contribute to liver inflammation and, ultimately, tissue necrosis.

The ability of hepatitis C virus to escape immune surveillance is the subject of much speculation. One likely means of viral persistence relies on the presence of closely related but heterogeneous populations of viral genomes. Further studies of these quasi-species enable classification of several genotypes and subtypes, which may have clinical implications.

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