Approxi mately 1.5% of the U.S. population is chronically infected with hepatitis C.

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such chronic infection can lead to cirrhosis and/or hepatocellular carcinoma, prophylactic ther apies
must be considered in the appropriate patient. Before 1992, transfusional therapy was an important
risk factor; intravenous drug use now accounts for the majority of new infections. The risk for
cirrhosis is about 20% at 20 years of infection. In this patient, histologic evidence of inflammation
without fibrosis suggests a 50% chance of progression over the next 10 years. Therefore, treatment is
indicated. The most effective treatment is probably interferon (recombinant interferon-2b, 3 million
units subcutaneously, thrice weekly) plus oral ribavirin. The combination has been shown to be
particularly useful for those who failed interferon monotherapy. Bothersome complications with
interferon are common; ribavirin (a nucleoside analogue that suppresses

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disease activity) is associated with hemolytic anemia, which is usually mild