ASSIGNMENT ON NEW DISCOVERIES ABOUT HEPATITIS C HERE I EXPLAIN YOU ABOUT INTRODUCTION HISTORY SYMPTOMS DIGNOSIS TREATMENTPREVENTIONdiscoveries about hepatitis c in 2020 WHAT IS HEPATITIS C ? The hepatitis C virus is a small, enveloped, positive-sense single-stranded RNA virus The hepatitis C virus is the cause of hepatitis C and some cancers such as liver cancer and lymphomas in humans. Scientific name: Hepacivirus: hepatitis c virusFamily: FlaviviridaeKingdom: OrthornavirAE HISTORY Hepatitis C was first discovered in the 1980s when it became apparent that there was a new virus (not hepatitis A or B) causing liver damage. Before being properly identified in 1989 it was originally known as non-A non-B hepatitis. In 1991 a screening process was developed making it possible to detect HCV in blood samples. The credit of discovery of HCV goes to Michael Houghton, Harvey Alter, and Charles Rice for which they are awarded 2020 Nobel Prize in Medicine. Hepatitis C is a blood-borne virus that predominantly infects the cells of the liver. This can result in inflammation and significant damage to the liver. It can also affect the liver’s ability to perform its essential functions. Although it has always been regarded as a liver disease - ‘hepatitis’ means ‘inflammation of the liver’ - recent research has shown that the hepatitis C virus (HCV) affects a number of other areas of the body. These can include the digestive system, the lymphatic system, the immune system and the brain. SYMPTOMS Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, pale faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes). DIAGNOSIS HCV infection is diagnosed in 2 steps: Testing for anti-HCV antibodies with a serological test identifies people who have been infected with the virus. If thantibodiese test is positive for anti-HCV, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection and the need for treatment. TREATMENT Hepatitis C medicines Hepatitis C is treated using direct-acting antiviral (DAA) tablets. DAA tablets are the safest and most effective medicines for treating hepatitis C. They're highly effective at clearing the infection in more than 90% of people. The tablets are taken for 8 to 12 weeks. The length of treatment will depend on which type of hepatitis C you have. Some types of hepatitis C can be treated using more than 1 type of DAA. NHS-approved hepatitis C medicines include: HARVONI sofosbuvir a combination of ledipasvir and sofosbuvir a combination of ombitasvir, paritaprevir and ritonavir Ribavirin ETC. PREVENTION There is no vaccine to prevent hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs with non-sterile injection equipment.

1. ASSIGNMENT ON
NEW DISCOVERIES ABOUT
HEPATITIS C
SUBMITTED BY ATIQA ZAHRA
SUBMITTED TO MAAM HABIBA
DEPARTMENT OF BIOCHEMISTRY

2. HEPATITIS C

3. INTRODUCTION
HISTORY
SYMPTOMS
DIGNOSIS
TREATMENT
PREVENTION
DISCOVERIES ABOUT HEPATITIS C IN 2020
HERE I EXPLAIN YOU ABOUT

4. THE HEPATITIS C VIRUS IS A SMALL, ENVELOPED,
POSITIVE-SENSE SINGLE-STRANDED RNA VIRUS
THE HEPATITIS C VIRUS IS THE CAUSE OF HEPATITIS C
AND SOME CANCERS SUCH AS LIVER CANCER AND
LYMPHOMAS IN HUMANS.
SCIENTIFIC NAME: HEPACIVIRUS: HEPATITIS C VIRUS
FAMILY: FLAVIVIRIDAE
KINGDOM: ORTHORNAVIRAE
WHAT IS HEPATITIS C ?

5. BIOCHEMISTRY

8. HISTORY
• Hepatitis C was first discovered in the
1980s when it became apparent that
there was a new virus (not hepatitis A or
B) causing liver damage. Before being
properly identified in 1989 it was
originally known as non-A non-B hepatitis.
In 1991 a screening process was
developed making it possible to detect
HCV in blood samples.

9. The credit of discovery of HCV goes to Michael
Houghton, Harvey Alter, and Charles Rice for
which they are awarded 2020 Nobel Prize in
Medicine.

10. CONTINUE…
• Hepatitis C is a blood-borne virus that
predominantly infects the cells of the liver.
This can result in inflammation and
significant damage to the liver. It can also
affect the liver’s ability to perform its
essential functions. Although it has always
been regarded as a liver disease - ‘hepatitis’
means ‘inflammation of the liver’ - recent
research has shown that the hepatitis C virus
(HCV) affects a number of other areas of the
body. These can include the digestive
system, the lymphatic system, the immune
system and the brain.

11. SYMPTOMS
• Following initial infection, approximately
80% of people do not exhibit any
symptoms. Those who are acutely
symptomatic may exhibit fever, fatigue,
decreased appetite, nausea, vomiting,
abdominal pain, dark urine, pale
faeces, joint pain and jaundice
(yellowing of skin and the whites of the
eyes).

12. CONTINUE…

13. DIAGNOSIS
• HCV infection is diagnosed in 2
steps: Testing for anti-HCV antibodies
with a serological test identifies people
who have been infected with the virus.
If the test is positive for anti-HCV
antibodies, a nucleic acid test for HCV
ribonucleic acid (RNA) is needed to
confirm chronic infection and the need
for treatment.

14. DIAGNOSIS…

15. TREATMENT
• Hepatitis C medicines
• Hepatitis C is treated using direct-acting
antiviral (DAA) tablets.
• DAA tablets are the safest and most effective
medicines for treating hepatitis C.
• They're highly effective at clearing the
infection in more than 90% of people.
• The tablets are taken for 8 to 12 weeks. The
length of treatment will depend on which type
of hepatitis C you have.
• Some types of hepatitis C can be treated using
more than 1 type of DAA.

16. CONTINUE..
• NHS-approved hepatitis C medicines include:
• HARVONI
• sofosbuvir
• a combination of ledipasvir and sofosbuvir
• a combination of ombitasvir, paritaprevir
and ritonavir
• Ribavirin ETC.

17. HARVONI

18. PREVENTION
• There is no vaccine to prevent hepatitis
C. The best way to prevent hepatitis C is
by avoiding behaviors that can spread
the disease, especially injecting drugs
with non-sterile injection equipment.
Hepatitis C can spread when a person
comes into contact with blood from an
infected person.

19. PREVENTION

20. Discoveries about hepatitis c in
2020
• Hepatitis C virus (HCV) accounts for hepatitis,
liver cirrhosis, hepatocellular carcinoma, and
liver transplantation.
• According to WHO, approximately 399,000 people
died of chronic HCV infection globally in 2016,
about 71 million people have chronic HCV
infections around the globe in 2020, and hence,
it is a plague of humankind.
• The credit of discovery of HCV goes to Michael
Houghton, Harvey Alter, and Charles Rice for
which they are awarded 2020 Nobel Prize in
Medicine.

21. • What does SVR mean in virology?
• SVR stands for sustained virologic
response. It means that 12 weeks or
more after you stop treatment, tests
can't find the hepatitis C virus in your
blood.

22. • What is IFN based therapy?
• Interferon-based therapy (IBT) has
been the standard of care for hepatitis
C virus (HCV) infection , in 2013
• With the use of pegylated interferon and
ribavirin jointly

23. We can now treat HCV through
DAAs
• Direct-acting antiviral (DAA) agents are
medications that doctors use to treat
hepatitis C. DAA agents contain a
combination of drugs to destroy the
hepatitis C virus (HCV). There are different
classes of DAA agents that combine to target
specific parts of the virus in order to destroy
it.
• Mechanistically, DAAs inhibit specific HCV
non-structural proteins (NS) that are vital
for its replication.

24. Discoveries about hepatitis c in
2020
• higher SVR has been found comparatively,
even in patients with chronic liver diseases.
However, due to excessive pain tolerated by
patients, interferon (IFN)-based therapy is
rapidly being replaced with IFN-free DAA
regimens.
• With the onset of resistance to DAA drugs,
CRISPR-Cas system can be used to modify
the viral genome to impair their ability to
develop resistance.

25. • As defined by phylogenetic and sequence
analysis of the HCV genome, the virus
contains six major genotypes, varying by
30 to 35% at the nucleotide level.
• Among the six genotypes and 70
subtypes, genotype 1 is found to be the
most common HCV genotype.

26. NOW IN 2020
• Researchers have explored out the best
treatment response to be in patients with
genotypes 2 and 3 of HCV.
• 24 weeks of treatment of the patients
having these genotypes with the combined
therapy leads to SVR rates of approximately
80%. However, even 48 weeks of combined
therapy given to patients with genotype 1
HCV gives SVR rates of approximately 40%
only. So, genotype 1 is said to be the most
difficult genotype to be treated.

27. • The 9.6 Kb genome of HCV undergoes
translation into a glycoprotein that is
processed into structural and non-
structural proteins (NS proteins). NS
proteins include NS3, NS4A, NS4B, NS5A,
and NS5B. Currently approved DAA is
found to target these NS proteins.

28. CONTINUE..
• Despite ineffectiveness in some patients,
the combined therapy of pegIFNα and
RBV is difficult to tolerate. Hence,
researchers focus on using therapies that
can inhibit viral production and can be
tolerated. This has been possible with the
use of DAA drugs. It has been found that
90% of the patients treated with DAAs
report reduction in HCV infection.

29. • HCV exhibits a high rate of replication.
• The virus multiplies at the rate of 10*12
virions produced daily.
• RNAdependent RNA polymerase (RdRp)
accounts for viral production.
• Mutation in this viral enzyme leads to the
emergence of resistance to DAA drugs, as
this enzyme is one of the targets of DAA
drugs.

30. • Furthermore, patients report psychiatric
illness after undergoing treatment with
DAA regimens, which also represents an
important barrier to HCV treatment,
including irritability, mood swings, and
even depression in about 21 to 58% of the
patients.

31. Mood of action

32. REFERENCE…
• https://pubmed.ncbi.nlm.nih.gov/335110
75/#:~:text=The%20credit%20of%20discov
ery%20of,first%20time%20in%20the%20hist
ory.