Review
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World J Gastroenterol. Aug 21, 2007; 13(31): 4168-4176
Published online Aug 21, 2007. doi: 10.3748/wjg.v13.i31.4168
Controversies in and challenges to our understanding of hepatitis C
Robert G Batey
Robert G Batey, Area Director, Drug and Alcohol Clinical Services, Hunter New England Area Health Services. Newcastle, New South Wales, Australia
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Robert Batey, Professor of Medicine, University of New South Wales, Bankstown Hospital, Eldridge Road, Bankstown. 2200, New South Wales, Australia. rbate@doh.health.nsw.gov.au
Telephone: +61-2-97229292 Fax: +61-2-97228570
Received: December 15, 2006
Revised: January 1, 2007
Accepted: January 4, 2007
Published online: August 21, 2007
Abstract

Discovered in 1989, the hepatitis C virus (HCV) continues to cause significant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. This paper discusses a number of areas where progress in the management of the HCV have not kept pace with the scientific understanding of the HCV. It is suggested that in the fields of HCV prevention and providing access to treatment, practice falls short of what could be achieved. The role of alcohol in the pathogenesis of HCV liver injury is discussed. Discrimination against those with HCV infection and particularly those in prison settings fails to match good clinical practice. The complicated processes of sharing information between specialty groups is also discussed in an attempt to optimise knowledge dissemination in this field.

Keywords: Hepatitis C, Alcohol, Injecting drug use, Prisons, Genetic variation, Cirrhosis, Liver cell cancer