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báo cáo khoa học: " Musings on genome medicine: Hepatitis C David G Nathan and Stuart H Orkin"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Musings on genome medicine: Hepatitis C David G Nathan and Stuart H Orkin | Nathan and Orkin Genome Medicine 2010 2 4 http genomemedicine.eom content 2 1 4 MUSINGS L__ Musings on genome medicine Hepatitis C David G Nathan and Stuart H Orkin Abstract Hepatitis C is a viral disease transmitted principally by blood which affects millions of people worldwide. A significant proportion of those affected develop severe liver disease as a result. Only a fraction of patients are responsive to interferon treatment highlighting the need for further research into genetic factors involved in response to therapy in order to optimize treatment. The only current approach for end-stage disease is liver transplant which ironically does not cure the condition and thus poses a clinical dilemma in the face of liver-donor shortage. One hundred and fifty million people are infected by hepatitis C virus HCV worldwide and chronic hepatitis C is now the leading indication for liver transplantation in the US 1 . Transmitted principally by blood HCV is passed by transfusion of inadequately screened blood and blood products and by intravenous drug use sexual and vertical transmission also occur but at substantially lower rates than in other blood-borne viral infections. Unsterile dental equipment accidental needle punctures in medical facilities and tattooing are also linked to transmission. Following acquisition of infection 70 to 85 of patients will develop persistent viremia usually for the duration of their lives. Not all of these will develop liver failure however - infection is often indolent for long periods. Nonetheless two decades after infection about 20 of HCV-infected subjects will have developed endstage liver disease 2 . Hepatitis C is now a more common cause of cirrhosis than alcoholism. Though chronic hepatitis is the major result of HCV infection there are other manifestations of the disease that stem from chronic inflammation and associated immune cell stimulation with cytokine release. These include arthritis antibody-mediated thrombocytopenia