{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:10:02Z","timestamp":1791173402302,"version":"4.1.0"},"reference-count":80,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2002,11,1]],"date-time":"2002-11-01T00:00:00Z","timestamp":1036108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2003,12,30]],"date-time":"2003-12-30T00:00:00Z","timestamp":1072742400000},"content-version":"vor","delay-in-days":424,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The hepatitis C virus (HCV) is a small enveloped RNA virus belonging to the family flaviviridae and genus hepacivirus. The HCV RNA genome is 9,600 nucleotides in length and encodes a single polyprotein that is post-translationally cleaved into 10 polypeptides including t3 structural (C, E1, and E2) and multiple nonstructural proteins ([NS] NS2 to NS5). The NS proteins include enzymes necessary for protein processing (proteases) and viral replication (RNA polymerase). The virus replicates at a high rate in the liver and has marked sequence heterogeneity. There are 6 genotypes and more than 90 subtypes of HCV, the most common in the United States being 1a and 1b (approximately 75%), 2a and 2b (approximately 15%), and 3 (approximately 7%). Acute hepatitis C is marked by appearance of HCV RNA in serum within 1 to 2 weeks of exposure followed by serum alanine aminotransferase (ALT) elevations, and then symptoms and jaundice. Antibody to HCV (anti-HCV) tends to arise late. In acute resolving hepatitis, HCV RNA is cleared and serum ALT levels fall to normal. However, 55% to 85% of patients do not clear virus, but develop chronic hepatitis C. Chronic hepatitis C is often asymptomatic, but is usually associated with persistent or fluctuating elevations in ALT levels. The chronic sequelae of hepatitis C include progressive hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Extra-hepatic manifestations include sicca syndrome, cryoglobulinemia, glomerulonephritis, and porphyria cutanea tarda. Knowledge of the course and outcome of hepatitis C is important in developing approaches to management and therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jhep.2002.36227","type":"journal-article","created":{"date-parts":[[2002,10,31]],"date-time":"2002-10-31T22:50:56Z","timestamp":1036104656000},"page":"s21-s29","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":119,"title":["Course and outcome of hepatitis C"],"prefix":"10.1097","volume":"36","author":[{"given":"Jay H.","family":"Hoofnagle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1053\/jhep.2002.36227-BIB1|cit1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1056\/NEJM200107053450107","article-title":"Hepatitis C virus infection","volume":"345","author":"Lauer","year":"2001","journal-title":"N Engl J Med"},{"key":"10.1053\/jhep.2002.36227-BIB2|cit2","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1007\/s007050050479","article-title":"Classification, nomenclature, and database development for hepatitis C virus (HCV) and related viruses: proposals for standardization","volume":"143","author":"Robertson","year":"1998","journal-title":"Arch Virol"},{"key":"10.1053\/jhep.2002.36227-BIB3|cit3","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1126\/science.2523562","article-title":"Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome","volume":"244","author":"Choo","year":"1989","journal-title":"Science"},{"key":"10.1053\/jhep.2002.36227-BIB4|cit4","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1126\/science.2496467","article-title":"An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis","volume":"244","author":"Kuo","year":"1989","journal-title":"Science"},{"key":"10.1053\/jhep.2002.36227-BIB5|cit5","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1002\/hep.510250637","article-title":"The molecular biology of hepatitis C","volume":"25","author":"Major","year":"1997","journal-title":"Hepatology"},{"key":"10.1053\/jhep.2002.36227-BIB6|cit6","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1128\/JVI.73.2.1165-1174.1999","article-title":"A phylogenetically conserved stem-loop structure at the 5\u2032 border of the internal ribosome entry site of hepatitis C virus is required for cap-independent viral transplantation","volume":"73","author":"Honda","year":"1999","journal-title":"J Virol"},{"key":"10.1053\/jhep.2002.36227-BIB7|cit7","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1128\/JVI.74.4.2046-2051.2000","article-title":"Hepatitis C virus-encoded enzymatic activities and conserved RNA elements in the 3\u2032 nontranslated region are essential for virus replication in vivo","volume":"74","author":"Kolykhalov","year":"2000","journal-title":"J Virol"},{"key":"10.1053\/jhep.2002.36227-BIB8|cit8","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1126\/science.282.5386.103","article-title":"Hepatitis C viral dynamics in vivo and the antiviral efficacy of interferon-\u03b1 therapy","volume":"282","author":"Neumann","year":"1998","journal-title":"Science"},{"key":"10.1053\/jhep.2002.36227-BIB9|cit9","doi-asserted-by":"crossref","first-page":"3225","DOI":"10.1128\/JVI.66.5.3225-3229.1992","article-title":"Hepatitis C virus (HCV) circulates as a population of different but closely related genomes: quasispecies nature of HCV genome distribution","volume":"66","author":"Martell","year":"1992","journal-title":"J Virol"},{"key":"10.1053\/jhep.2002.36227-BIB10|cit10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1055\/s-2007-1007262","article-title":"Genetic heterogeneity of hepatitis C virus: quasispecies and genotypes","volume":"15","author":"Bukh","year":"1995","journal-title":"Semin Liver Dis"},{"key":"10.1053\/jhep.2002.36227-BIB11|cit11","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJM199908193410802","article-title":"The prevalence of hepatitis C virus infection in the United States, 1988 through 1994","volume":"341","author":"Alter","year":"1999","journal-title":"N Engl J Med"},{"key":"10.1053\/jhep.2002.36227-BIB12|cit12","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1002\/hep.1840200605","article-title":"Genotypic analysis of hepatitis C virus in American patients","volume":"20","author":"Mahoney","year":"1994","journal-title":"Hepatology"},{"key":"10.1053\/jhep.2002.36227-BIB13|cit13","doi-asserted-by":"crossref","first-page":"868","DOI":"10.7326\/0003-4819-124-10-199605150-00002","article-title":"Distribution of hepatitis C virus genotypes determined by line probe assay in patients with chronic hepatitis C seen at tertiary referral centers in the United States. 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