Diagnosis and treatment of chronic hepatitis C infection

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Abstract
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 use or transfusion of blood products before the implementation of antihepatitis C virus screening of blood donors in 1992. Seroprevalence among injecting drug users is more than 80%, and this remains a major risk factor for newly acquired hepatitis C virus infection in the developed world. Community based strategies for prevention of infection in these high risk groups are needed urgently but depend on resources (box 1). Screening of volunteer blood donations in developed nations has significantly reduced transfusion related hepatitis. Most countries in the developing world do not, however, have adequate screening procedures, and only about 40% of donated blood is tested for the virus. Occupational, vertical, and sexual transmission account for only a minority of new cases of hepatitis C virus infection. Sexual transmission of hepatitis C virus among monogamous partners is rare, but testing is often carried out for reassurance (box 2). See bmj.com for contact …