Hepatitis C has six genotypes, with 1, 2, and 3 being the most common. It is a blood-borne disease that attacks the liver and can cause liver failure. The virus can be transmitted through various means, and the acute phase is the most treatable. Different genotypes may respond differently to treatment, with genotypes 2 and 3 having higher cure rates. A vaccine that works against all genotypes has not been developed yet.
There are six major genotypes of hepatitis C, named 1, 2, 3, 4, 5, and 6. Hepatitis C is a blood-borne disease caused by the liver C virus (HCV). The virus attacks the liver, often without symptoms for many years, and can eventually cause liver infection, scarring, and ultimately failure. All hepatitis C genotypes, however, can be managed with treatment, although the exact indications may change depending on the genotype and subtype. Hepatitis C genotypes 1, 2, and 3 are the most common, and 2 and 3 have the most successful cure rates.
The hepatitis C virus is transmitted through intravenous drug use; sex; blood transfusions and organ transplants before HCV screening was required; dirty instruments for medical use, piercings or tattoos; or in utero from mother to child. The first to six months after infection is called the acute phase, and is the period of time when the disease is most treatable. Most people, however, do not experience any symptoms during this time and do not contract the disease until it has developed into its chronic phase and started causing liver scarring. Symptoms during the acute phase mimic mild flu symptoms, and chronic hepatitis C can be characterized by jaundice, nausea, decreased appetite, fatigue, joint pain, mood changes, and sleep disturbances. As the disease progresses to cirrhosis or extensive scarring, it can cause enlarged veins or varices, fluid accumulation in the abdomen or ascites, impaired liver function, and confusion or coma.
The hepatitis C virus is a very small RNA virus or a virus that uses RNA as its genetic material. The various genotypes share the same basic form of the virus, with RNA inside and an outer layer composed of proteins and enzymes, which allows the virus to hijack liver cells to reproduce.
Different hepatitis C genotypes have slightly different genetic makeup, however, allowing the virus to elude scientists’ attempts to develop a vaccine that works against all hepatitis C genotypes and the many subtypes. While the genotype may determine the length of treatment and the likelihood of success, it is not thought to determine the extent of liver damage. Some studies have also indicated that different genotypes may respond differently to different types of interferon treatments.
Hepatitis C genotypes 1, 2, and 3 are the most common genotypes, especially in the United States. HCV 1 has two subtypes, 1a and 1b. 1a is the most common type of hepatitis C in North and South America and 1b is the most common type in Europe and Asia. It is more difficult to treat than genotypes 2 or 3 and is usually treated with higher doses of ribavirin or interferon over a longer period of time. Genotype 2 has three subtypes, 2a, common to China and Japan, 2b, common to the United States and Northern Europe, and 2c, common to Southern and Western Europe. Genotype 3 is most common in the South Pacific. Both hepatitis C genotypes 2 and 3 have shorter treatment periods, usually about six months, lower doses of ribavirin or interferon, and higher cure rates.
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