The light of day for people with hepatitis C

  The prevalence of hepatitis C virus (HCV) infection in the Chinese population is 1.6%, and the annual incidence of hepatitis C in mainland China is 6.01 per 100,000 people, with HCV infection increasing with age.  Genotypes: HCV genotypes 1b and 2 are the most common in the mainland Chinese population; Complications: HCV genotype 1b is associated with the incidence of hepatocellular carcinoma (HCC) and is a high risk factor for HCC; other related complications include cirrhosis, hyperlipidemia, ascites and portal hypertension; the 5-year survival rate of HCV with cirrhosis is 73.8%; the 5-year survival rate after liver transplantation of HCV with HCC is 39.6%, lower than that of HBV 39.6%, which is lower than that of HBV with HCC.  The main cause of death in HCV is HCC. Due to the fact that routine physical examinations do not check for hepatitis C antibodies and the lack of knowledge about hepatitis C among some primary care physicians, a large number of hepatitis C patients are still not diagnosed and treated in a timely manner in China.  The previous standard treatment for hepatitis C was interferon combined with ribavirin, which some patients could not tolerate or had poor efficacy in achieving complete clearance, leaving many patients with hepatitis C, especially those with hepatitis C-related cirrhosis or liver cancer, at a loss for treatment.  With the application of direct antiviral agents (DAAs) such as protease inhibitors, HCV infection has been resolved in the United States, i.e., hepatitis C virus can be completely controlled and cleared. Recent treatment of chronic HCV infection with a combination of several DAAs for 3 months has resulted in a 90% viral clearance efficiency (SVR) for refractory chronic hepatitis C (genotype 1), compared to 100% for other types. The problem is that it is currently expensive, and there are difficulties in promoting its application in developing countries; secondly, although HCV virus clearance and liver tissue inflammation have been significantly relieved, liver fibrosis is still evident, and the rate of liver tumors is still high. Therefore, how to actively prevent and control the occurrence of liver fibrosis and liver tumor after HCV virus clearance will be an important issue in the future.