Foreword

Virus-host interactions (dependencies) and their intricate interplay are always phenomenal and of paramount interest to investigate molecular epidemiology and pathogenesis of all viral infections. However; complex cross-talks between hepatitis C virus (HCV) and host cells involving a plethora of genes and cell signaling pathways leading asymptomatic acute hepatitis C infection to chronic hepatitis C (CHC) and further durable, sustained, and insidious extrahepatic manifestations are still mysterious, murky, inconclusive, and even more, remains to elucidate. The world has always seen paradigms in HCV infection biology and therapeutics since its discovery in the late 1980s by gene cloning methods instead of the use of conventional tissue culture, or classical virological techniques. We can say that the world could not be able to see this revolutionary advancement in molecular biology techniques, state-of-the-art diagnostic tools, sophisticated protocols of clinical trials, astute knowledge of molecular drug targets, and serendipitous design and development of drug molecules without HCV discovery that once labeled as the ‘silent epidemic’ afflicting even more than 58 million peoples around the globe nowadays. Before the advent and approval of all oral interferon-free direct-acting antivirals, the gold standard of care, a combination therapy including pegylated interferon plus ribavirin achieved sustained clearance of HCV and subsequent improvements in liver disease in only 60% of treated patients. It has been a long haul, a big haul, but we’ve made it with the current landscape of HCV therapeutics to cure harder-to-treat special HCV subpopulations including cirrhotic, decompensated cirrhotic, HCV/HIV or HCV/HBV co-infections, and liver transplant or post-transplant patients with virus recurrence. Despite oral direct-acting antivirals having started to bear fruit in real-world clinical settings against HCV, unmet challenges, barriers, and hurdles in HCV diagnostics and treatment accessibility still prevail that need to surmount and overcome to reduce the global healthcare burden of HCV and to achieve WHO striving goal of HCV elimination by 2030.

This thought-provoking book tends to cover a comprehensive and up-to-date overview of the latest advancement in HCV infection biology, perplexing molecular clinical pathology, novel diagnostic tools, fortuitous anti-HCV therapeutic options on the horizons, management of difficult-to-treat subpopulations, and imperative compensatory therapies against hepatitis C infection in the late stage of their development. The book intends to cover the latest guidelines issued by the US FDA, AASLD/IDSA (American Association for the Study of Liver Diseases/Infectious Diseases Society of America), ECDC (European Center for Disease Prevention and Control), and NYSDOH-AI (New York State Department of Health Aids Institute) on HCV screening, diagnosis, treatment and management for the clinicians, physicians, infectious disease experts, and primary care providers (nurses and paramedics). The contents of the book not only provide ABC of HCV infection, diagnostic tools, and treatment strategies to common and interested readers but also address current information about some pretty mind-boggling aspects of hepatitis C biology, immunology, pharmacology, therapeutics, and vaccinology to obtain relevant answers with thoughtful explanations of some outstanding problems in the field nowadays. The book also covers up-to-date guidelines about patient screening, treatment protocols, and optimization of therapy in real-world clinical settings.

The book also summarizes unanswered questions currently faced by investigators in the intriguing molecular pathogenesis of CHC in humans, and physicians, clinicians, hepatologists, and healthcare officials are concerned with HCV clinical diagnosis and therapeutics. I hope that this book will also be a valuable addition to hepatology for curious undergraduate and postgraduate students pursuing a new career in HCV medicine or newcomer in hepatitis C research to broaden their knowledge and gain a wide perspective of the field. The multi- and interdisciplinary presentation of information in this book would open a new school of thought for postdoctoral fellows to search for new horizons and milestones in hepatitis C research. The book closes while shedding light on remarkable and amalgamated efforts by the World Health Organization (WHO), health policymakers, and public healthcare providers to a proper ending of this ‘silent epidemic’ from the world by 2030.

Both authors of the book (Imran Shahid and Qaiser Jabeen) are agile, bright, and very active investigators in the concerned field of hepatitis C research with more than 10 and 20 years of experience respectively. I wish that this web-based, as well as hard copy format book, would rapidly become an international referral and guideline in hepatitis C infection biology, diagnostics, and therapeutics.