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Role of Immune Response in HCV

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The liver cell response to hepatitis C, a positive-strand RNA virus of the flaviviridiae, varies considerably from acute disease to chronic hepatitis, and from inapparent infection to cirrhosis. The cellular injury to the host depends on host—viral interactions (Table 1 ): in general, the more active the immune response, the greater the cellular injury. If viral infection leads to cell lysis, then the organism dies as is seen in fulminant hepatitis, a relatively rare event (<1% response seen after hepatotrophic viral infection and rare in HCV infection). If cellular dysfunction occurs, then clinical disease results. If viral replication occurs without cellular damage, then inapparent infection results. If the individual is exposed without attachment to the host, then no infection occurs
Table 1  Host-Cell Response: Outcome of HCV Infection

Cellular response

Host response

HCV

Cell lysis

Death of organism

Fulminant failure rare

Viral multiplication without cell damage

Asymptomatic infection

Inapparent disease <15%

Cell dysfunction

Climical disease

Common

Exposure without attachment

Exposure, no infection

Unknown

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