Hepatitis C, “a silent epidemic”
- March 14, 2018
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Every year, 3-4 million new infections are estimated, and more than 350,000 people die every year from diseases related to Hepatitis C. 75-85% of the infected can not spontaneously defeat the virus and 60-70% of these develop chronic hepatitis. Depending on the geographical areas and the concomitant factors, 5-20% of patients develop cirrhosis of the liver and between 1% and 5% of these patients die of hepato-carcinoma or cirrhosis. 25% of all liver cancer cases are due to HCV infection (World Health Organization, July 2012).
Approximately one million Italians are affected by Hepatitis C, but it is estimated that the virus infected is about twice as large, most of them in the southern regions. In Italy the average prevalence of standardized age infection is about 4%, the highest in Europe. Moreover, a strong north-south gradient is observed: in Southern Italy about 8% of the population is positive for viral markers, with peaks of 12% of the population in the 46-60 age group (Ansaldi et al, Journal of Medical Virology, 2005). HCV, alone or in combination with other factors such as alcohol or hepatitis B virus, is the major cause of cirrhosis (72%) and liver cancer (76%) in Italy.
In our country, cirrhosis is the fifth leading cause of death with 10,000 deaths a year (ISTAT data, 2003). The progression of Hepatitis C is highly variable among the many affected individuals, and yet the factors that determine the progression of the disease are still unclear. Antiviral therapy is based on the administration of Interferon-α and Ribavirin, drugs that activate the immune system of the host to defend against the virus, but only half of the patients respond to this therapy, which is also associated with frequent side effects. The efforts of pharmaceutical companies are focusing on the development of new drugs that block the virus directly, and various research groups are studying its mechanism of action.