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. 2012 Apr 20;2(2):7-25.
doi: 10.5493/wjem.v2.i2.7.

Hepatitis C virus-host interactions: Etiopathogenesis and therapeutic strategies

Affiliations

Hepatitis C virus-host interactions: Etiopathogenesis and therapeutic strategies

Mohamed Hassan et al. World J Exp Med. .

Abstract

Hepatitis C virus (HCV) is a significant health problem facing the world. This virus infects more than 170 million people worldwide and is considered the major cause of both acute and chronic hepatitis. Persons become infected mainly through parenteral exposure to infected material by blood transfusions or injections with nonsterile needles. Although the sexual behavior is considered as a high risk factor for HCV infection, the transmission of HCV infection through sexual means, is less frequently. Currently, the available treatment for patients with chronic HCV infection is interferon based therapies alone or in combination with ribavirin and protease inhibitors. Although a sustained virological response of patients to the applied therapy, a great portion of patients did not show any response. HCV infection is mostly associated with progressive liver diseases including fibrosis, cirrhosis and hepatocellular carcinoma. Although the focus of many patients and clinicians is sometimes limited to that problem, the natural history of HCV infection (HCV) is also associated with the development of several extrahepatic manifestations including dermatologic, rheumatologic, neurologic, and nephrologic complications, diabetes, arterial hypertension, autoantibodies and cryglobulins. Despite the notion that HCV-mediated extrahepatic manifestations are credible, the mechanism of their modulation is not fully described in detail. Therefore, the understanding of the molecular mechanisms of HCV-induced alteration of intracellular signal transduction pathways, during the course of HCV infection, may offer novel therapeutic targets for HCV-associated both hepatic and extrahepatic manifestations. This review will elaborate the etiopathogenesis of HCV-host interactions and summarize the current knowledge of HCV-associated diseases and their possible therapeutic strategies.

Keywords: Extrahepatic; Hepatitis C virus; Hepatocellular carcinoma; Signalling; Therapy.

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Figures

Figure 1
Figure 1
Hepatitis C virus genomic organization,replication,translation and generation of functional proteins. Proteins encoded by the hepatitis C virus (HCV) genome. HCV is formed by an enveloped particle harboring a plus-strand RNA of about 9.6 kb. The genome carries a long open-reading frame (ORF) encoding a polyprotein precursor of 3010 amino acids. Translation of the HCV ORF is directed via a 5’ nontranslated region (NTR) functioning as an internal ribosome entry site; it permits the direct binding of ribosomes in close proximity to the start codon of the ORF. The HCV polyprotein is cleaved co- and post-translationally by cellular and viral proteases into ten different products, with the structural proteins core (C), envelop 1 (E1) and envelop 2 (E2) located in the N-terminal third, whereas, the nonstructural (NS2, NS3, NS4A, NS4B, NS5A, NS5B) replicative proteins are located in the remainder. Putative functions of the cleavage products are shown.
Figure 2
Figure 2
A proposed model for the consequences resulting from the interference of hepatitis C virus with signal transduction processes in host cells. HCV: Hepatitis C virus; TNFR: Tumor necrosis factor receptor; JAK: Janus kinase; EGFR: Endothelial growth factor receptor; IFN: Interferon; IFNR: IFN receptor; TRAF: Tumor necrosis factor associated factor; TRADD: TNFR-associated protein with death domain; JAK: Janus kinase; JNK: c-Jun N-terminal kinase; SOCS: Suppressor of cytokine signaling; PI3K: Phosphatidylinositol-3-kinase; ERK: Extracellular regulated protein kinase; RIP: Receptor-interacting protein; ROS: Reactive oxygen species; STAT: Signal transducers and activators of transcription; NF-κB: Nuclear factor κB; IL: Interleukin; PPAR: Peroxisome proliferator-activated receptor.
Figure 3
Figure 3
A schematic view for the molecular mechanisms,which are involved in the regulation of hepatitis C virus-induced associated cell proliferation. A central role for mitogen-activated protein kinase signaling pathways in the modulation of hepatitis C virus-associated hepatocellular carcinoma is also demonstrated. HCV: Hepatitis C virus; AP-1: Activator protein-1; JNK: c-Jun N-terminal kinase; CREB: cAMP response element-binding protein; ERK: Extracellular regulated protein kinase.
Figure 4
Figure 4
A proposed model for hepatitis C virus - mediated effects in liver cells and the modulatory role of transforming growth factor β in the regulation of both angiogenesis (A) and hepatocellular carcinoma (B). PKC: Protein kinase C; HCV: Hepatitis C virus; AP-1: Activator protein-1; CREB: cAMP response element-binding protein; JNK: c-Jun N-terminal kinase; ERK: Extracellular regulated protein kinase; TGF: Transforming growth factor; VEGF: Vascular endothelial growth factor; ROS: Reactive oxygen species; PPAR: Peroxisome proliferator-activated receptor.
Figure 5
Figure 5
A suggested model for hepatitis C virus -associated inflammation and the role of tumor necrosis factor α in the regulation of this mechanism. HCV: Hepatitis C virus; JNK: c-Jun N-terminal kinase; AP-1: Activator protein-1; NF-κB: Nuclear factor κB; PPAR: Peroxisome proliferator-activated receptor; TNF: Tumor necrosis factor; STAT: Signal transducers and activators of transcription.
Figure 6
Figure 6
Proposed model for the molecular mechanisms, which are involved in the regulation of hepatitis C virus-associated steatosis. HCV: Hepatitis C virus; ROS: Reactive oxygen species; PPAR: Peroxisome proliferator-activated receptor.
Figure 7
Figure 7
A schematic overview for the interference of hepatitis C virus with cytokines-associated Janus kinase/signal transducers and activators of transcription and cytokines-associated pathways. HCV: Hepatitis C virus; JAK: Janus kinase; EGFR: Endothelial growth factor receptor; IFN: Interferon; IFNR: IFN receptor; TRAF: Tumor necrosis factor associated factor; JAK: Janus kinase; SOCS: Suppressor of cytokine signaling; RIP: Receptor-interacting protein; ROS: Reactive oxygen species; STAT: Signal transducers and activators of transcription; NF-κB: Nuclear factor κB; IL: Interleukin; PPAR: Peroxisome proliferator-activated receptor.
Figure 8
Figure 8
A proposed view for molecular mechanisms, which are involved in the modulation of hepatitis C virus-mediated insulin resistance during the course of hepatitis C virus infection. TNF: Tumor necrosis factor; HCV: Hepatitis C virus; SOCS: Suppressor of cytokine signaling; ROS: Reactive oxygen species; STAT: Signal transducers and activators of transcription; IRS: Insulin receptor substrates.

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