Hepatitis C virus infection: A review of the current and future aspects and concerns in Pakistan

Abstract

Hepatitis C virus (HCV) is the major etiological agent of hepatitis. It infects 200 million people worldwide and 85% of them could develop chronic hepatitis, liver function failure or hepatocellular carcinoma. Hepatitis C is rapidly emerging as a major health problem in developing countries like Pakistan with prevalence rate of 10% and genotype 3a is the most prevalent. Here, approximately 80% of infections proceed to chronic infection and infected blood is the primary route of spread. In Pakistan, about 75% of patents do not receive standard anti HCV therapy (Interferon + Ribavirin) and of the 25% that do receive such treatment, the SVR rate is 60 -70%. This review is designed to cover the information about the status of HCV in Pakistan with major focus on its prevalence, genotypes, current diagnostic assays, available therapies and treatment outcomes. The present review further emphasizes the need to uncover exact HCV prevalence rate in the country, to develop diagnostic assays based on local genotype, to understand the interaction between HCV genotype 3a genes and cell line genes responsible HCV pathogenesis. In addition, this review discusses the need for the generation of infectious pseudo particle of HCV as a potential vaccine, to investigate DNA base vaccine, or siRNA-based anti HCV approaches for our local genotypes.