10 February 2006

10 February 2006

Leonard B. Seeff – 10 February 2006 – Much controversy surrounds the issue of the natural history of hepatitis C virus (HCV) infection. Many authorities view the disease as inexorably progressive with a high probability of advancing over time to cirrhosis and occasionally hepatocellular carcinoma (HCC) and, therefore, likely to be responsible for causing death.

10 February 2006

10 February 2006

Bruce R. Bacon – 10 February 2006 – Approximately 30% of patients with chronic hepatitis C have normal serum alanine aminotransferase (ALT) levels and another 40% have ALT levels that are less than twice the upper limit of the normal range. Most patients with normal ALT levels have mild degrees of inflammation with mild or no fibrosis, and the rate of disease progression is reduced compared with that in patients with elevated ALT levels. Some patients with normal ALT levels have advanced fibrosis and cirrhosis on liver biopsy.

Geetanjali Chander, Mark S. Sulkowski, Mollie W. Jenckes, Michael S. Torbenson, H. Franklin Herlong, Eric B. Bass, Kelly A. Gebo – 10 February 2006 – This systematic review addressed 3 issues regarding current treatments for chronic hepatitis C: (1) efficacy and safety in treatment‐naive patients; (2) efficacy and safety in selected subgroups of patients; and (3) effects on long‐term clinical outcomes. Electronic databases were searched for articles from January 1996 to March 2002.

10 February 2006

Adrian M. Di Bisceglie, Jay H. Hoofnagle – 10 February 2006 – The highest response rates to antiviral therapy for the treatment of chronic hepatitis C have been achieved using the combination of peginterferon and ribavirin. Recently completed controlled trials have reported rates of sustained virological response (SVR) between 50% and 60% in patients treated with higher doses of peginterferon and ribavirin, which was 5% to 1O% higher with standard doses of interferon alfa and ribavirin. The major determinant of outcome of therapy is hepatitis C virus (HCV) genotype.

Hashem B. El‐Serag – 10 February 2006 – Chronic infection with hepatitis C virus (HCV) is a major risk factor for development of hepatocellular carcinoma (HCC). In general, HCC develops only after 2 or more decades of HCV infection and the increased risk is restricted largely to patients with cirrhosis or advanced fibrosis. Factors that predispose to HCC among HCV‐infected persons include male sex, older age, hepatitis B virus (HBV) coinfection, heavy alcohol intake, and possibly diabetes and a transfusion‐related source of HCV infection. Viral factors play a minor role.