Transmission of hepatitis C virus: self-limiting hepatitis or chronic hepatitis?

It has been suggested that hepatitis C virus (HCV) is selectively transmitted to a new host as an infectious clone from multiple HCV variants (quasispecies) in the donor. Most individuals with HCV infection develop chronic hepatitis, but approximately 15%-40% of them clear the virus spontaneously and the hepatitis is resolved in a self-limiting manner in the acute phase of infection. This difference in the outcome of acute hepatitis C is attributable to both viral characteristics and genetic regulation of infection. In particular, the evolutionary dynamics of the infecting virus and host genetic polymorphisms pertaining mainly to the immune system, including polymorphisms in the region of the Interleukin 28B gene encoding interferon-λ-3, are associated with susceptibility to HCV infection.