Hepatitis C virus: the growing challenge.

BACKGROUND: Hepatitis C virus (HCV) is a major cause of liver disease worldwide. In industrialized countries, intravenous drug users (IDUs) are the main reservoir of infection. Relatively little information is available on HCV in the developing world. SOURCES OF DATA: Peer reviewed publications and presentations at major academic meetings. AREAS OF AGREEMENT: HCV-related cirrhosis and death from hepatocellular carcinoma are likely to rise dramatically in the next three decades. Urgent intervention is required both to minimize the burden of disease in those already infected and to reduce the incidence of new infections, particularly in the IDU population. AREAS OF CONTROVERSY: Current models of care and commissioning in the UK and other countries do not adequately identify or treat HCV infection in IDUs. Most strategies focus on disease prevention and do not target new infections. GROWING POINTS: New models of care are currently being developed and validated. AREAS TIMELY FOR DEVELOPING RESEARCH: The development of new models of HCV replication will transform our understanding and capacity to treat HCV infection.