BMJ  2006;332:1013-1017 (29 April), doi:10.1136/bmj.332.7548.1013

Clinical review

Diagnosis and treatment of chronic hepatitis C infection

Keyur Patel, assistant professor of medicine1, Andrew J Muir, assistant professor of medicine1, John G McHutchison, professor of medicine1

1 Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27707, USA

Correspondence to: J G McHutchison mchut001@mc.duke.edu

The first 150 words of the full text of this article appear below.

Introduction

Hepatitis C virus was identified in 1989 as a major cause of the parenterally transmitted non-A non-B hepatitis. Chronic hepatitis C virus infection affects an estimated 170 million people worldwide1 and is characterised by varying degrees of inflammation and hepatic fibrosis. A proportion of patients with chronic infection will develop progressive liver damage with cirrhosis and complications of end stage liver disease over 20 to 40 years. Chronic infection is now the leading indication for liver transplantation in developed nations and will continue to pose an important health and economic burden during the next 10 to 20 years. Here we outline the criteria for screening, diagnosing, and treating patients with hepatitis C virus infection and describe potential future therapies.

Prevalence and transmission of hepatitis C virus infection

Hepatitis C virus (see bmj.com for description of virus) is transmitted by parenteral or permuscosal exposure to infected blood or body fluids. Many patients will give a history of injecting drug . . . [Full text of this article]

Clinical course and disease progression

Diagnosis of hepatitis C virus infection

Treatment decisions

Treatment options

Assessing early response

Individualising treatment

Management of side effects of antiviral therapy

Other patient populations

Future treatment options

Conclusions


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