Impact of HCV genetic differences on pathobiology of disease

Abstract

Multiple HCV genotypes have been isolated worldwide. Genotype seems to be involved in the main pathological aspects of HCV infection. Insulin resistance, steatosis and progression toward cirrhosis, fibrosis and hepatocellular carcinoma establish and develop following genotype-specific mechanisms. Moreover genotype influences pharmacological treatment in term of dose and duration. Pathways involved in cell proliferation, apoptosis, lipid metabolism, insulin and interferon signaling are impaired to a different extent among genotypes, leading to distinct pathological settings. Genotype 1 is associated with a more aggressive disease with increased insulin resistance, worst response to therapy, higher risk of cirrhosis and hepatocellular carcinoma development, while genotype 3 is associated with increased steatosis and fibrosis. The identification and characterization of HCV types and subtypes provides insight into the different outcome of HCV infection and responsiveness to therapy. In the present article, we focused on the pathogenicity of HCV genotypes and their effect on disease progression and treatment.

Keywords::

• fibrosis
• HCV genotypes
• hepatocellular carcinoma
• insulin resistance
• steatosis
• treatment outcome

Financial & competing interests disclosure

This work was supported by the Italian Ministry of Health from grant RC1003GA51, through the Research Unit of Gastroenterology, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo (FG), Italy. The Italian Ministry of Health fund RC1003GA51 supported the postdoctoral research position for Maria Ripoli. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.