Hepatitis C virus (HCV) is the prototype human pathogen having been discovered purely by molecular biology rather than by traditional virology tools. Since the early 1970s, the existence of a virus responsible for the majority of parenterally transmitted non-A, non-B hepatitis had been suspected, but it was not until 1989 that Michael Houghton and coworkers, at Chiron Corporation, identified and cloned HCV. It took another 10 years to develop an efficient system to study HCV replication in vitro, thus paving the way to large-scale screening of small molecules with direct antiviral activity. Meanwhile, the details of the HCV transmission, pathogenesis and natural history were unravelled, leading to a full appreciation of the global health burden associated with this infection. HCV affects about 2.4 % of the world population, and molecular biology advances may again contribute substantially—through the development of safe and efficacious drugs—to its eradication in the near future. The main focus of this chapter is to provide an overview of the innate and adaptive immune responses against HCV. In addition, we will describe the latest developments in the treatment of acute and chronic hepatitis C.
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