Clinical virology of hepatitis C virus

Hepatitis C virus (HCV) infects approximately 170 million individuals worldwide. Prevention of HCV-infection complications is based on antiviral therapy with the combination of pegylated interferon-a and ribavirin. The use of serological and virological tests has become essential in the management of HCV infection. These tests diagnose infection, guide treatment decisions and assess the virological response to antiviral therapy. Anti-HCV antibody testing and HCV-RNA testing are used to diagnose acute and chronic hepatitis C. The HCV genotype should be systematically determined before treatment, as it determines the indication, duration of treatment, dose of ribavirin and virological monitoring procedure. HCV-RNA monitoring during therapy is used to tailor treatment duration in HCV genotype 1 infection, and molecular assays are used to assess the end-of-treatment and, most importantly, the sustained virological response, for example the end point of therapy.