Clinician's guide to hepatitis C

Hepatitis C virus infection is common, often silent, and almost always chronic and can lead to cirrhosis and hepatocellular cancer, Deaths related to chronic hepatitis are expected to increase dramatically in the future, Many cases of infection are asymptomatic and are undiagnosed because of a lack of recognition by patients and physicians, All patients currently or previously at risk of infection should undergo screening, including those who received blood transfusions before 1992, Interferon is the only effective therapy, but disappearance of virus is sustained in only 10 to 15% of patients, The combination of interferon and oral ribavirin therapy may increase the sustained response rate to about 40%. New agents such as hepatitis C virus-specific protease inhibitors may be available in the next 5 to 10 years, and treatment is evolving toward multiple-drug regimens analogous to those used for human immunodeficiency virus (HIV) infection, In contrast to public funding for drug development in HIV, such funding for hepatitis C has been limited.