Epidemiology

In New Zealand, less than one-third of cases of hepatitis C virus (HCV) have been identified. Sexual transmission of HCV is the main route of transmission in New Zealand. The majority of chronic infections occur in the 40-to-60 year age group.

Disease progression

HCV infection is spontaneously cleared in 80% of individuals. Chronic hepatitis C is not associated with the development of liver cancer or liver failure. Almost one-quarter of New Zealanders with chronic HCV infection already have cirrhosis.

Liver disease

Staging of liver disease is important with regard to developing a treatment plan for patients with chronic HCV infection. Staging of liver disease is required for acute hepatitis C. Regular surveillance is not recommended for individuals with cirrhosis.

Management

Modification of lifestyle factors has no impact on the prevention of disease progression. Complementary and alternative medicines (CAMs) are widely used in individuals to treat symptoms and prevent disease progression. CAMs have shown efficacy in preventing fibrosis progression.

Management

Antiviral therapy represents the best means of preventing disease progression. Ribavirin has a direct effect on the hepatitis C virus. The combination of pegylated interferon plus ribavirin cures the majority of individuals with HCV infection.