Detection of Hepatitis C Virus in the Semen of Infected Men and Reproductive Assistance in HCV Discordant Couples: An Overview

Hepatitis C virus (HCV) is a single-stranded RNA member of the Flaviviridae family. The virus has an extraordinary heterogeneity owing to its lack of ability to correct copying errors made during viral replication. Many of its nucleotide changes result in a non-functional genome or a replication-incompetent virus (lethal mutants), whereas others persist and account for the incredible viral diversity. Viral heterogeneity takes several forms depending upon the degree of diversity, such as quasispecies (families of different, but highly similar, strains that develop within an infected host over time, with a nucleotide sequence homology greater than 95 %) and over decades and centuries, the degree of HCV diversity has evolved into several distinct genotypes of the virus. This heterogeneity is extremely important in the diagnosis of infection, pathogenesis of disease, and the response to treatment; it prevents the development of conventional vaccines, allows the virus to escape eradication by the host’s immune system, and affects the completeness of the response to antiviral therapies. With the advent of new antivirals, HCV infection could in theory be curable in nearly all patients, and with focused strategies to screen and cure current infections, in addition to preventing new HCV cases, the number of infections can be significantly lowered or eliminated within the next 15–20 years.