CMAJ • February 28, 2006; 174 (5). doi:10.1503/cmaj.1030034.
© 2006 CMA Media Inc. or its licensors
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Review

Hepatitis C: a review for primary care physicians

Tom Wong and Samuel S. Lee

From the Public Health Agency of Canada and the University of Ottawa, Ottawa, and the University of Toronto, Toronto, Ont. (Wong), and from the Department of Medicine, Liver Unit, University of Calgary, Calgary, Alta. (Lee)

Correspondence to: Dr. Tom Wong, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Jeanne Mance Bldg., Room 647B, Tunney's Pasture, PL1906B, Ottawa ON K1A 0K9; tom_wong{at}hc-sc.gc.ca

Abstract

Primary care physicians see many of the estimated 250 000 Canadians chronically infected with the hepatitis C virus (HCV). Of this number, about one-third are unaware they are infected, which constitutes a large hidden epidemic. They continue to spread HCV unknowingly and cannot benefit from advances in antiviral therapy that may clear them of the virus. Many HCV-infected people remain asymptomatic, which means it is important to assess for risk factors and test patients accordingly. The third-generation enzyme immunoassay for HCV antibodies is a sensitive and specific test, although the presence of the virus can be confirmed by polymerase chain reaction testing for HCV RNA in some circumstances. Pegylated interferon-{alpha} and ribavirin combination therapy clears the virus in about 45%–80% of patients, depending on viral genotype. Preventive strategies and counselling recommendations are also reviewed.




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