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World J Gastroenterol. Jul 28, 2014; 20(28): 9270-9280
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9270
Epidemiology and natural history of hepatitis C virus infection
Mei-Hsuan Lee, Hwai-I Yang, Yong Yuan, Gilbert L’Italien, Chien-Jen Chen
Mei-Hsuan Lee, the Institute of Clinical Medicine, National Yang-Ming University, Taipei 155, Taiwan
Hwai-I Yang, Chien-Jen Chen, the Genomics Research Center, Academia Sinica, Taipei 115, Taiwan
Hwai-I Yang, the Graduate Institute of Clinical Medical Science, China Medical University, Taichung 40242, Taiwan
Hwai-I Yang, the Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung 40242, Taiwan
Yong Yuan, Gilbert L’Italien, the Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ 08543, United States
Gilbert L’Italien, the Yale University School of Medicine, New Haven, CT 06510, United States
Chien-Jen Chen, the Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 155, Taiwan
Author contributions: Lee MH generated the figures and wrote the manuscript; Lee MH, Yang HI, Yuan Y, L’Italien G and Chen CJ contributed to the writing of the manuscript.
Correspondence to: Chien-Jen Chen, ScD, Professor, the Genomics Research Center, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 115, Taiwan. chencj@gate.sinica.edu.tw
Telephone: + 886-2-27899402 Fax: + 886-2-27853208
Received: September 23, 2013
Revised: March 4, 2014
Accepted: April 27, 2014
Published online: July 28, 2014
Abstract

Hepatitis C virus (HCV) affects 130-210 million people worldwide and is one of the major risk factors for hepatocellular carcinoma. Globally, at least one third of hepatocellular carcinoma cases are attributed to HCV infection, and 350000 people died from HCV related diseases per year. There is a great geographical variation of HCV infection globally, with risk factors for the HCV infection differing in various countries. The progression of chronic hepatitis C to end-stage liver disease also varies in different study populations. A long-term follow-up cohort enrolling participants with asymptomatic HCV infection is essential for elucidating the natural history of HCV-caused hepatocellular carcinoma, and for exploring potential seromarkers that have high predictability for risk of hepatocellular carcinoma. However, prospective cohorts comprising individuals with HCV infection are still uncommon. The risk evaluation of viral load elevation and associated liver disease/cancer in HCV (REVEAL-HCV) study has followed a cohort of 1095 residents seropositive for antibodies against hepatitis C virus living in seven townships in Taiwan for more than fifteen years. Most of them have acquired HCV infection through iatrogenic transmission routes. As the participants in the REVEAL-HCV study rarely receive antiviral therapies, it provides a unique opportunity to study the natural history of chronic HCV infection. In this review, the prevalence, risk factors and natural history of HCV infection are comprehensively reviewed. The study cohort, data collection, and findings on liver disease progression of the REVEAL-HCV study are described.

Keywords: Hepatitis C virus, Epidemiology, Risk evaluation of viral load elevation and associated liver disease/cancer, Long-term liver progression

Core tip: This review includes summary tables describing the epidemiology of hepatitis C virus (HCV) infection in previous studies and recent findings from the risk evaluation of viral load elevation and associated liver disease/cancer in HCV study.