Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Feb 6, 2016; 7(1): 33-40
Published online Feb 6, 2016. doi: 10.4292/wjgpt.v7.i1.33
Hepatitis C virus: A time for decisions. Who should be treated and when?
Bashar M Attar, David H Van Thiel
Bashar M Attar, Cook County Health and Hospitals System, Rush University Medical Center, Chicago, IL 60612, United States
David H Van Thiel, Advanced Liver and Gastrointestinal Disease Center, Berwyn, IL 60402, United States
Author contributions: Both the authors contribute to collect of data, synthesis, and write of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bashar M Attar, MD, PhD, MPH, Cook County Health and Hospitals System, Rush University Medical Center, 1901 West Harrison Street, Chicago, IL 60612, United States. battar@rush.edu
Telephone: +1-312-8647213 Fax: +1-312-8649214
Received: June 24, 2015
Peer-review started: June 24, 2015
First decision: August 3, 2015
Revised: September 16, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: February 6, 2016
Core Tip

Core tip: This study presents the burden of hepatitis C virus (HCV) infection. Current guidelines limit treatment to those with advanced liver disease (Metavir F-3 or F-4 fibrosis). This represents a small fraction of those infected having the worse prognosis. They are unlikely to infect others. In contrast, the much larger group F-0 to F-2 is the vectors for additional infections. The plague of HCV can only be eliminated if the larger groups that infect others are treated. The cost of treating this larger population is expensive but much less expensive than treating only those with advanced fibrosis in the long run.