[Hepatitis C virus infection. Overview. SEVHEP (Swiss Experts on Viral Hepatitis)]

The hepatitis C virus (HCV) shows a pronounced polymorphism with six genotypes and many subtypes. The virus is generally not cytopathogenic. Immunological defence mechanisms are probably essential for the pathogenecity. An acute hepatitis is relatively rare; the infection becomes chronic in over 70%. The data on the occurrence of chronic hepatitis, cirrhosis and hepatocellular carcinoma are conflicting. The age at infection, the gender, coinfections with HBV and HIV and alcohol consumption play a role. The basis of diagnostics is the anti-HCV screening test with clear indications for the measurement of the genotype and of HCV-RNA. The combination of interferon-alpha and Ribavirin is the therapy of choice with improved success. HCV is most often transmitted through contaminated syringes and needles, i.v. drug users having the greatest incidence and prevalence. Vertical and sexual HCV transmission is relatively rare. It is estimated that the HCV prevalence in Switzerland is 0.75-1%, afflicting 50,000-70,000 individuals. Over the next years the number of HCV associated decompensated liver cirrhosis, liver transplantation and death will grow. Efforts of collaboration in the field are undertaken including the establishment of a Swiss HCV cohort study.