HEPATITIS-C VIRUS-INFECTION - CLINICAL ASPECTS AND TREATMENT WITH INTERFERON-ALFA

Screening for antibodies to hepatitis C virus (HCV) has substantially reduced the risk of HCV infection from transfusion of blood and blood products. Nevertheless, new infections may continue to occur. These in fections may be caused by donor infections that escape detection or by insufficient decontamination of blood products during preparation. Fr equently, HCV infection becomes chronic, is clinically silent, and can be associated with extrahepatic illnesses and liver cancer. A recent outbreak of HCV infection in patients who received intravenous immunog lobulin has permitted study of this infection in immunocompromised hos ts. Some evidence indicates that this infection is more virulent in th ese patients, and our experience at Children's Hospital, Boston, Massa chusetts, substantiates this finding. In this article, epidemiology an d modes of transmission of HCV, pathogenesis of HCV infections, differ ential diagnosis, and clinical features of HCV infection in both child ren and adults are discussed. Particular attention is given to the ser ologic findings seen in the spectrum of diseases associated with chron ic HCV infection. The mechanisms of action of interferon alfa treatmen t of HCV infections are discussed. However, results of interferon alfa treatment of patients with HCV infection at Children's Hospital are p reliminary.