Hepatitis C Virus (HCV): The Pathogen Behind Hepatitis C

Hepatitis C is caused by the hepatitis C virus (HCV)—a small, enveloped, positive-sense, single-stranded RNA virus in the Flaviviridae family, genus Hepacivirus.

Key Virologic Features

• High mutation rate: RNA-dependent RNA polymerase lacks proofreading → quasispecies swarm → immune evasion, vaccine challenge
• 7 major genotypes (1–7), 67+ subtypes: Geographic variation; genotype guides treatment duration/regimen
• Hepatotropism: Replicates primarily in hepatocytes via CD81, SR-BI, claudin-1, occludin receptors

Disease Burden

• ~58 million chronic infections globally (WHO 2024)
• Leading cause of cirrhosis, hepatocellular carcinoma (HCC), liver transplant
• Often asymptomatic for decades—"silent epidemic"

Modern Treatment

Direct-acting antivirals (DAAs) (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir, etc.) achieve >95% cure (SVR12) in 8–12 weeks, pan-genotypic, well-tolerated. WHO targets elimination by 2030.

No vaccine yet. Prevention: harm reduction, blood safety, infection control.