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Describe the genome of HCV.
(+) ssRNA with an IRES in the 5' NTR.
How is HCV translated?
The viral genome has one ORF which is translated as a single polyprotein that is subsequently cleaved by cellular and viral proteases.
What enzymes does the HCV genome code for?
*proteases for polyprotein cleavage
*RNA-dependent RNA polymerase
How many forms of HCV exist?
There are 6 genotypes and ~100 subtypes.
Following acute infection, what clincal presentation does HCV show?
Most (70-100%) patients convert to chronic carriers who then show sequential episodes of acute inflammation. 40% of these carriers will develop cirrhosis and HCC.
What is the key immune player in clearance of HCV?
Why is immunity against HCV typically less than effective? What can be inferred from a positive anti-HCV blood test?
The virus shows antigenic drift within a single patient ("quasi species") and thus is able to evade immune attacks. The presence of anti-HCV signals ongoing infection and viremia - not recovery.
How is HCV transmitted?
*body fluids
How is HCV diagnosed?
ELISA for HCV antibodies.
What problems have been encountered in the development of a vaccine for HCV?
There are multiple serotypes and even within a single patient there is antigenic drift.
What treatment is available for HCV? What kind of success is seen?
Interferon alone or in combination with ribavirin is used. There have been mixed results including supression of viremia with rebound of the virus following discontinuation of therapy.

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