CURRENT STATUS OF THE MOLECULAR-GENETICS OF HEPATITIS-C VIRUS AND ITS UTILIZATION IN THE DIAGNOSIS OF INFECTION

Background: Since the discovery of hepatitis C virus (HCV) as a major cause of non-A non-B hepatitis, advances have been made in our understanding of the molecular biology of HCV and its relatedness to the flaviviruses and pestiviruses. The use of molecular techniques to construct an antibody assay has enabled the accumulation of information concerning the natural history and pathogenesis of HCV infection. Objectives: The objective was to review the literature to March 1994 on the structure, function and genetics of HCV and to correlate these findings with approaches to diagnosis that have contributed to our understanding Of HCV infections. Study design: We reviewed the virological and medical literature from 1988 to March of 1994 with a focus on the stated objectives. Results: Although the structure of HCV has been well-defined, our knowledge of the function of all the genes of HCV is incomplete. Structural core and envelope proteins as well as enzymes have been described. The 5' end of the polypeptide is most conserved. Genotyping of isolates varies according to the part of the gene examined. Several genotypes exist and tend to predominate in global populations. Antibodies to the various proteins can be measured by EIA assays and positive specimens often require confirmatory testing. Uniquely sensitive nucleic acid detection systems for RNA amplified by PCR have enabled a better understanding of the natural history, epidemiology and responses to treatment. Conclusions: Well-designed studies for the detection of nucleic acid, antibodies and antigens using a variety of viral gene products will provide even more information about HCV infections and help lead to treatment and prevention.