Hepatitis C: Part I. Routine serologic testing and diagnosis

Hepatitis C, which is caused by the hepatitis C virus (HCV), is a major pub lic health problem in the United States. HCV is most efficiently transmitte d through large or repeated percutaneous exposures to blood. Most patients with acute HCV infection develop persistent infection, and 70 percent of pa tients develop chronic hepatitis. HCV-associated chronic liver disease resu lts in 8.000 to 10,000 deaths per year, and the annual costs of acute and c hronic hepatitis C exceed $600 million. An estimated 3.9 million Americans are currently infected with HCV, but most of these persons are asymptomatic and do not know they are infected. To identify them, primary health care p rofessionals should obtain a history of high-risk practices associated with the transmission of HCV and other bloodborne pathogens from all patients. Routine testing is currently recommended only in patients who are most like ly to be infected with HCV.