LYCOS RETRIEVER 
Hepatitis C: United States
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Until recently, the primary treatment for hepatitis C was a drug called alpha interferon. In July 1998 the Federal Drug Agency (FDA) approved a new drug called ribavarin. This new drug is now being used in combination with alpha interferon and appears to be increasing treatment success rates. According to a report in the July 1998 National Alliance of State and Territorial AIDS Directors (NASTAD) HIV Prevention Community Planning Bulletin, the combination therapy has been shown to be up to 50 percent effective, increased from 20 percent with alpha interferon alone. However, the February 1999 NASTAD Bulletin indicated that the FDA approved combination packaged as Rebetron is a relatively expensive treatment with a retail price of up to $1,440 a month.
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The concept of cure in a case of an infectious disease, like hepatitis C, includes the complete elimination of the virus from the body, not just limitation of its action (remission). For this concept to be applied, one requires the modern knowledge of, and testing for, viral particles, something that has become common place only during the past few years. The PCR (polymerase chain reaction) test for hepatitis C viral RNA is, therefore, the current standard for measuring the status of the disease, and the determination method of a true cure. The test measures the "viral load," or the quantity of virus in the bloodstream. In someone who is cured, the viral load should be undetectable (technically, one cannot measure tiny amounts of virus, so one can only say below the limit of detection) and then continue to remain undetectable in the absence of any virus suppressing therapies for several years. At this time, it is not known whether hepatitis C can be cured according to this strict standard, partly because there hasn't been enough time (since testing was developed) to determine whether any treatment has a long-term successful result.
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Hepatitis C is caused by the hepatitis C virus (HCV). Most persons who acquire acute HCV infection either have no symptoms or have a mild clinical illness. However, chronic HCV infection develops in 75%-85% of those acutely infected, with chronic liver disease developing in 60%-70% of chronically infected persons (1). Chronic hepatitis C is the leading cause for liver transplantation in the United States.
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Hepatitis C is a blood-borne virus, often contacted by sharing needles, and can lead to chronic liver disease and liver cancer. Disease rates have fallen in the United States but are on the rise in developing nations.
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No vaccine for hepatitis C is available, and prophylaxis with immune globulin is not effective in preventing HCV infection after exposure. Reducing the burden of HCV infection and disease in the United States requires implementation of both primary and secondary prevention activities. Primary prevention reduces or eliminates HCV transmission; secondary prevention activities reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy, if appropriate.
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Hepatitis C, a chronic disease caused by a blood borne pathogen, affects four to five times as many Americans as HIV. Often undetected and left untreated, the virus is responsible for at least 30 to 50 percent of liver cancer cases in the United States.
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