Hepatitis C: public health strategies

Hepatitis C virus (HCV) is a major global public health problem. As with many recently discovered diseases, there is still considerable controversy within the scientific community regarding the prevalence, incidence and socio-economic burden of acute and chronic hepatitis C. New infections continue to occur. Given the substantial morbidity and mortality attributable to HCV-related chronic liver disease, each country, irrespective of its economic status, should develop an HCV-related public health plan for the prevention of new HCV infections. The source of HCV infection includes transfusion of blood or blood products from unscreened donors, transfusion of blood products that have not undergone viral inactivation, parenteral exposure to blood through the use of contaminated and inadequately sterilized instruments and needles used in medical, dental and "traditional" medicine, individuals undergoing procedures such as haemodialysis, persons who participate in high risk sexual practices, household or sexual contacts with HCV-infected persons and infants of HCV-infected mothers. In many countries, the relative contribution of the various sources of infection has not been defined with population-based epidemiological studies. Wherever possible, such studies should be performed to enable countries to prioritise their preventive measures and to make the most appropriate use of available resources.