The in vitro culture of hepatitis C virus and approaches to the control of replication

HCV是肝脏疾病的主要原因，目前全球约有2亿人感染，其中包括20万澳大利亚人。HCV与其他黄病毒不同。最值得注意的是，大约80%的人会出现持续性感染，这是大量携带者的原因。这种感染可能是终身的，40-50%的携带者会发展为严重的肝脏疾病，包括肝癌。HCV是目前西方世界肝移植的主要单一指标。这些携带者也可以将病毒传播给未感染的个体。在血库中进行筛查已将输血后的传播减少到几乎为零。然而，尽管共用受污染针头的个人代表了主要的高风险人群，但约30%的携带者没有公认的传播风险因素，并且已确认在医院传播给患者。因此，很明显，普通人群中的成员仍然可能受到感染。据估计，澳大利亚每年有10，000例新病例。最好的治疗方法是α-干扰素和利巴韦林的组合，但这只对40-50%的携带者有效。此外，许多患者不能耐受这些药物，并且成本限制了对一小部分携带者的治疗。因此，在澳大利亚只有大约6 500名携带者得到治疗。肝脏诊所的大量积压和澳大利亚50%患者的病毒耐药性意味着除非开发新的疗法，否则这些患者将无法接受治疗。预防病毒感染的最有效方法是接种疫苗。因此，开发新的抗病毒药物和HCV疫苗是当务之急。由于单次肝移植的费用为10万美元，因此开发此类药物可能具有成本效益。然而，有必要开发合适的细胞培养系统来测试推定的抗病毒剂。

HCV is a major cause of liver disease and around 200 million people are currently infected worldwide, including 200,000 Australians. HCV differs to other flaviviruses. Most notably, around 80% of individuals develop a persistent infection, accounting for the large number of carriers. This infection is probably life-long and 40-50% of carriers will develop serious liver disease, including liver cancer. HCV is currently the leading single indicator for liver transplantation in the western world. These carriers can also transmit the virus to uninfected individuals. Screening in the blood banks has reduced transmission after blood transfusion to virtually zero. However, although individuals who share contaminated needles represent a major high risk population, around 30% of carriers have no acknowledged transmission risk factors, and transmission to patients in hospitals has been recognised. As a result, it is clear that members of the general population may still become infected. It has been estimated that there are 10,000 new cases each year in Australia. The best available treatment is a combination of interferon-alpha and ribavirin, but this is only successful in 40-50% of carriers. Moreover, many patients fail to tolerate these drugs and the cost restricts treatment to a small proportion of carriers. As a result,only approx 6,500 carriers have been treated in Australia. A huge backlog in the liver clinics and the resistant nature of the virus in 50% of patients in Australia mean that these patients will not be treated unless new therapies are developed. The most effective means to prevent virus infections is by vaccination. Thus the development of novel antivirals and a vaccine for HCV are priorities. Since the cost of a single liver transplant is $100,000 the development of such agents is likely to be cost effective. However, it is necessary to develop suitable cell culture systems to test putative antiviral agents.