CMAJ • February 28, 2006; 174 (5). doi:10.1503/cmaj.1030034.
© 2006 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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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)


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  		Table 1.

 

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  		Box 1.

 

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  		Fig. 1: Natural history of hepatitis C virus (HCV) infection.68 *Note that 60%–75% of patients are asymptomatic at this stage.

 

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  		Fig. 2: Algorithm for testing for hepatitis C infection.63,93,98 *If the result of the anti-HCV EIA is indeterminate, a qualitative HCV RNA PCR is required. {dagger}The threshold for a positive HCV RNA assay result is > 50 IU/mL. HCV = hepatitis C virus, anti-HCV = HCV antibodies, EIA = enzyme immunoassay, ALT = alanine transferase, PCR = polymerase chain reaction.

 

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  		Box 2.

 

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  		Table 2.

 

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  		Fig. 3: Algorithm for hepatitis C antiviral therapy. *If the viral load drops by less than 2 logs compared with that at baseline, therapy can be stopped because the likelihood of achieving a sustained virologic response is less than 3%.63,93,96,105,106 {dagger}Therapy should be stopped if the virus is not cleared at 24 weeks, since sustained virologic response is very unlikely.93,107 HCV = hepatitis C virus, PEG-IFN = pegylated interferon, PCR = polymerase chain reaction.

 

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  		Table 3.

 

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  		Box 3.