Fortnightly Review: A rational approach to the management of hepatitis C infection

BMJ 1996;312:357-364 (10 February)

Education and debate

Fortnightly Review: A rational approach to the management of hepatitis C infection

G M Dusheiko, reader in medicine,^a S Khakoo, research fellow,^a P Soni, South African MRC fellow,^a L Grellier, British Digestive Foundation research fellow ^a

^a University Department of Medicine, Royal Free Hospital School of Medicine, London NW3 2QG

Correspondence to: Dr Dusheiko.

Summary points

The natural course of chronic hepatitis C is not fully defined
A range of disease exists--from mild asymptomatic infection with few consequences to serious disease with dire sequelae
Pretreatment assessments of viral load and genotype or serotype may help in predicting response
It is difficult to indicate the prognosis for younger patients with mild disease; they may need to be considered for treatment, so that the opportunity to avoid later disease is not forfeited
It is not yet clear whether patients who are more responsive to interferon have a better prognosis

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