Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3443
Revised: January 16, 2014
Accepted: March 6, 2014
Published online: April 7, 2014
The mechanisms that regulate disease progression during hepatitis C virus (HCV) infection and the response to treatment are not clearly identified. Numerous studies have demonstrated that a strong host immune response against HCV favors HCV clearance. In addition, genetic factors and metabolic machinery, particularly cholesterol modulation, are involved in HCV infection. It is likely that the interplay between all of these factors contributes to the outcome of HCV infection. In recent years, the world has experienced its largest epidemic of obesity. Mexico and the United States are the leading sufferers from this epidemic at the global level. Obesity is associated with the development of numerous pathologies including hypercholesterolemia which is one of the eight most important risk factors for mortality in Mexico. This may be related to the course of HCV infection in this population. Here, we focus on the urgent need to study the progression of HCV infection in relation to ethnic characteristics. Discoveries are discussed that hold promise in identifying immune, metabolic and genetic factors that, in conjunction, could be therapeutic targets or predictors of the progression of HCV infection.
Core tip: Immunologic, metabolic and genetic factors are involved in the progression of hepatitis C virus (HCV) infection and the response to treatment. The significant increase in obesity worldwide, including in Mexico, imposes a new metabolic stress factor in patients with HCV infection. Given that the lipid components associated with HCV infection are finely modulated, it is possible that the progression of HCV infection may be regulated by the characteristics of the population’s lipid composition.