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Progression to chronic HCV occurs in 55% to 86% of infected people, and persistent infection is a major cause of cirrhosis, end stage liver disease, and hepatocellular carcinoma. The detection of HCV antibodies should be performed initially to screen at risk populations. In those who are seropositive, HCV viraemia should be assessed to determine if chronic HCV is present. The HCV genotype should also be determined, as this is the strongest predictor of response to available treatment. A liver biopsy is very often helpful because it can estimate degree of hepatic fibrosis, identify concurrent diseases that might contribute to hepatic injury, and aid in selection of patients for treatment. The decision to start antiviral therapy should take into account potential contraindications to therapy, patient motivation, severity of disease, age, and HCV genotype. Combination therapy with weekly subcutaneous pegylated interferon and daily oral ribavirin is the standard of care for treating patients with chronic HCV.<\/jats:p>","DOI":"10.1136\/pgmj.2004.025403","type":"journal-article","created":{"date-parts":[[2005,6,3]],"date-time":"2005-06-03T16:53:24Z","timestamp":1117817604000},"page":"376-382","source":"Crossref","is-referenced-by-count":19,"title":["Management of chronic hepatitis C"],"prefix":"10.1093","volume":"81","author":[{"suffix":"III","given":"V","family":"Lo Re","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine , Philadelphia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J R","family":"Kostman","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Medicine and Division of Infectious Diseases, Presbyterian Medical Center , Philadelphia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2005,6,3]]},"reference":[{"key":"2023042408275793500_R1","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/S1286-4579(02)01649-0","article-title":"Global epidemiology and burden of hepatitis C","volume":"4","author":"Kim","year":"2002","journal-title":"Microbes Infect"},{"key":"2023042408275793500_R2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1056\/NEJM197504102921502","article-title":"Transfusion-associated hepatitis not due to viral hepatitis type A or B","volume":"292","author":"Feinstone","year":"1975","journal-title":"N Engl J Med"},{"key":"2023042408275793500_R3","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1056\/NEJM198911303212202","article-title":"Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis","volume":"321","author":"Alter","year":"1989","journal-title":"N Engl J Med"},{"key":"2023042408275793500_R4","doi-asserted-by":"crossref","first-page":"296","DOI":"10.7326\/0003-4819-132-4-200002150-00008","article-title":"Pathogenesis, natural history, treatment, and prevention of hepatitis C","volume":"132","author":"Liang","year":"2000","journal-title":"Ann Intern Med"},{"key":"2023042408275793500_R5","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/S0140-6736(03)15109-4","volume":"362","author":"Poynard","year":"2003","journal-title":"Lancet"},{"key":"2023042408275793500_R6","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJM199908193410802","article-title":"The prevalence of hepatitis C virus infection in the United States, 1988 through 1994","volume":"341","author":"Alter","year":"1999","journal-title":"N Engl J Med"},{"key":"2023042408275793500_R7","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1056\/NEJM199606273342602","article-title":"Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection","volume":"334","author":"Conry-Cantilena","year":"1996","journal-title":"N Engl J Med"},{"key":"2023042408275793500_R8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1056\/NEJM200107053450107","article-title":"Hepatitis C virus infection","volume":"345","author":"Lauer","year":"2001","journal-title":"N Engl J Med"},{"key":"2023042408275793500_R9","first-page":"65","volume":"72","author":"World Health Organisation","year":"1997","journal-title":"Wkly Epidemiol Rec"},{"key":"2023042408275793500_R10","first-page":"425","article-title":"Hepatitis C\u2014global prevalence (update)","volume":"74","author":"World Health Organisation","year":"1999","journal-title":"Wkly Epidemiol Rec"},{"key":"2023042408275793500_R11","first-page":"18","article-title":"Hepatitis C\u2014global prevalence (update)","volume":"75","author":"World Health Organisation","year":"2000","journal-title":"Wkly Epidemiol Rec"},{"key":"2023042408275793500_R12","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1002\/hep.1840360703","article-title":"Management of hepatitis C: 2002-June 10\u201312, 2002","volume":"36","author":"National Institutes of Health Consensus Development Conference Statement","year":"2002","journal-title":"Hepatology"},{"key":"2023042408275793500_R13","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1056\/NEJM199904223401602","article-title":"Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. 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