Review Article

A New Twist to a Chronic HCV Infection: Occult Hepatitis C

Box 1

Major developments in HCV identification, replication mechanisms, life cycle sequence, and treatment.
1975: recognition of non-A, non-B hepatitis (HCV) as a specific entity,
 1989: HCV specifically identified,
 1991-1992: initial approval and use of interferon (IFN) therapy for HCV,
 1993: HCV genome organization and polyprotein processing defined,
 1996: first three-dimensional structure of HCV protein, the NS3-4A protease,
 1997: first infectious clone of HCV isolated,
 1998: ribavirin added to interferon therapy,
 1999: replicon system developed enabling in vitro study of the virus replication,
 2003: development of functional HCV pseudoparticles,
 2003: initial proof-of-concept of HCV replication utilizing a protease inhibitor,
 2004: first reports of occult HCV infection (OCI),
 2005: recombinant infectious HCV produced in tissue culture,
 2009: IL28B polymorphisms identified that affect viral responses to therapy,
 2011: approval of the first direct acting antivirals (DAA) agents,
 2013: complete HCV life cycle defined in humanized mice,
 2013: all oral therapy utilizing DAA approved.