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CLINICIAN'S CORNER
Chronic Hepatitis C Virus Infection
Steven L. Flamm, MD
JAMA. 2003;289:2413-2417.
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INTRODUCTION
Chronic hepatitis C virus (HCV) infection is a common worldwide problem. The infection may progress to cirrhosis with the subsequent development of complications such as ascites, encephalopathy, variceal bleeding, and hepatocellular carcinoma. Thus, early detection and therapy is of great importance. There has been substantial progress in understanding various aspects of HCV infection, including the virology, epidemiology, natural history of chronic infection, and medical therapy. The objective of this article is to provide relevant clinical information regarding the contemporary approach to patients with chronic HCV infection.
Virology
Hepatitis C virus is an RNA virus and a member of the Flaviviridae family. The RNA viruses have high mutation rates and have evolved different genotypes of HCV based on nucleotide sequence heterogeneity. There are 6 known genotypes with genotype 1 (75%), genotype 2 (approximately 10%), and genotype 3 (approximately 10%) being the most common in the United . . . [Full Text of this Article]
Epidemiology
Diagnostic Testing
Natural History
Extrahepatic Manifestations
Medical Therapy
Early Stopping Rules
Adverse Effects and Contraindications
Adherence
Whom to Treat?
Future Investigation
Author Affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
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