Review underplayed important public health issues

EDITOR—We were disappointed that McCarthy and Wilkinson's review of recent advances in hepatology underplayed important public health issues and treatment options surrounding hepatitis C virus.1 In Western Europe about 5 million people are chronic carriers of hepatitis C virus, and in industrialised countries the virus accounts for 40% of cases of end stage cirrhosis and 30% of liver transplants.2 Hepatitis C is thus an important health problem.

Recent data confirm that combination antiviral treatment with ribavirin and interferon is better than interferon alone, with a 38-43% sustained response rate (polymerase chain reaction negative) with 12 months of combination treatment compared with 13-19% with interferon alone.3 4 Although ribavirin has been supplied for use only in trials in the United Kingdom, it is imminently to be licensed for patients who relapse after interferon …