The role of scavenger receptor BI in hepatitis - eTheses Repository ...

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Aside from considerations of the infecting viral genotype, patient
characteristics are also important to consider when administering treatment.
A significant proportion of patients are in ‘hard to treat’ groups, whereby a
patient’s lifestyle or health makes therapeutic intervention difficult. Such
individuals include intravenous drug users, who may continually expose
themselves to HCV and patients with alcohol associated liver damage (278).
As a result, even in societies with active treatment programs, infection and
disease remain difficult to control, especially as there is no vaccine currently
available against HCV (12, 278).
For patients who present with cirrhosis, treatment options are more limited as
they are typically less responsive to anti-viral therapy, although treatment
does slow disease progression (275). The prognosis for individuals presenting
with decompensated cirrhosis or hepatocellular carcinoma (HCC) is poor; with
5 year survival rates of 50% in untreated patients (275). Liver transplantation
is generally the only suitable course of action in these cases, however the
allograft is rapidly re-infected and the clinical features of hepatitis reoccur
within 100 days (29), as such 5 year survival rates only increase to ~70%
patients post transplant (275).
About one fifth of patients will experience a self-limiting acute infection,
culminating in the clearance of the virus. Elucidating the determinants of
spontaneous resolution has been difficult, as the vast majority of individuals
who clear infection are asymptomatic (87). However, studies using both