Pathobiologic effects of hepatitis C.

Hepatitis C virus (HCV) is the main cause of non-A, non-B hepatitis around the world. It frequently leads to chronic hepatitis which may progress to cirrhosis and hepatocellular carcinoma (HCC). Characteristic, although not pathognomonic, histologic changes in chronic hepatitis C include bile duct damage and lymphoid aggregates in portal tracts. Hepatocyte and bile duct injury seem to be mediated by both a direct cytopathic effect of HCV and immune mechanisms, perhaps triggered by HCV. Most HCC are related to HCV, HBV, or both. HCV appears to persist and replicate in hepatocytes during malignant transformation, but it is not clear whether the virus plays a direct or indirect role in hepatocarcinogenesis.