Abstract
Hepatitis C is an intricate liver disease. Its causative agent, hepatitis C virus (HCV) has been studied intensively for many years to spot out new therapeutic approaches. Even after more than 20 years since its discovery, HCV poses uninterrupted public health problem around the globe. HCV infection is present in approximately in 200 million people in world which includes Pakistan also. The treatment therapy of interferon alpha (IFNα) plus ribavirin has failed to eliminate the virus completely from the body of patients. So no ideal treatment for HCV available that is equally effective against all type of HCV genotypes. The improved therapy is peginterferon and ribavirin (PR). Recently with combined therapy additional direct acting antiviral agents has been approved by FDA, which is recommended for genotype 1a are telaprevir and boceprevir. The molecular mechanism by which it is show resistance is
still subject of investigation. HCV genotype 1a shows greater hindrance to treatment compare to other genotypes. This treatment regimen is not an ideal treatment for HCV, because the success rate is only 40 to 50 percent in case of infection of genotype 1 or 4, develops a SVR. The main key problem in the management of HCV is high mutation rates
which produces diverse population of mutants called quasispecies. Variation in the quasi-species population confers remarkable potential on HCV to adjust according to the changing host situation and helps in evading the host immune system and in differential sensitivity to IFN treatment. NS5A protein is associated with interferon resistance. We have travelled through the era of Interferon (1991), ribavirin (1998) pegylated interferon plus ribavirin (2002) to triple therapy pegylated interferon + ribavirin + boceprevir and telaprevir (2011), quadruple therapy (2013) and now moving ahead to all oral quad therapy.
Abrar Hussain, Muhammad Idrees, Madiha Akram, Liaqat Ali, Arif Malik, Muhammad Asif. (2013) The Molecular Architecture of HCV: A review, Journal of Applied and Emerging Sciences, Volume 4, Issue 1.
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