At least 200 million individuals are currently infected with hepatitis C virus (HCV) worldwide.
Approximately 30%-50% of patients respond to interferon/ribavirin combination therapy. Response to interferon therapy depends mainly on viral and host genetic factors. The HCV is continually mutating which allows the virus to evade the immune system and overcome interferon treatment. The 5'untranslated region (UTR) of the viral genome is the most conserved region within the viral RNA, and its structural/thermodynamic stability is a key factor for efficient binding to host ribosomes for initiating viral polyprotein translation. It is believed that more than 100 host proteins bind to this region of the virus that is termed IRES (internal ribosome entry sequences). Specific mutations in this region would alter the structure stability of viral RNA, its protein translation efficiency and consequently its ability to replicate, and thus response to therapy. Although several mutations have been observed in different HCV genotypes, no studies have investigated mutations in IRES of HCV genotype 4a; the predominant HCV genotype in Egypt and whether such mutations correlate to therapeutic response.
A research team led by Dr. Hassan M Azzazy from Egypt addressed this issue and their study will be published on March 28, 2009 in the World Journal of Gastroenterology .