Viral Hepatitis C

Hepatitis C virus (HCV) is a blood-borne virus endemic throughout the world and a major cause of liver disease. HCV is transmitted parenterally and less than 25% of cases of acute infection become clinically evident. Most patients who acquire HCV cannot eliminate it spontaneously and develop a chronic infection with a high propensity to evolve into liver cirrhosis and hepatocellular carcinoma. Furthermore, HCV plays a role in a wide range of extrahepatic manifestations, including lipid and glucose metabolic imbalances. Therefore, the clinical and prognostic impact of HCV infection depends not only on liver-related complications and death, but also on extrahepatic manifestations. Although viral replication occurs primarily in the liver, HCV is able to infect and replicate into most human cells and tissues causing local and systemic inflammation. Consequently, HCV infection is considered a systemic disease. In recent years, direct-acting antiviral agents have been approved and these drugs are able to achieve HCV clearance in up to 98% of cases with a positive clinical impact on hepatic and extrahepatic manifestations. This favorable therapeutic scenario has allowed the World Health Organization to hope for the global eradication of viral hepatitis C by 2030.