title: Controversies in and challenges to our understanding of hepatitis C.
abstract: Discovered in 1989, the hepatitis C virus (HCV) continues to cause significant morbidity and mortality world-wide despite a huge research commitment to defining and understanding the virus and the disease it causes. This paper discusses a number of areas where progress in the management of the HCV have not kept pace with the scientific understanding of the HCV. It is suggested that in the fields of HCV prevention and providing access to treatment, practice falls short of what could be achieved. The role of alcohol in the pathogenesis of HCV liver injury is discussed. Discrimination against those with HCV infection and particularly those in prison settings fails to match good clinical practice. The complicated processes of sharing information between specialty groups is also discussed in an attempt to optimise knowledge dissemination in this field.
authors: Drug and Alcohol Clinical Services, Hunter New England Area Health Services, Newcastle, New South Wales, Australia. rbate@doh.health.nsw.gov.au
authors: Robert G
authors: RG
authors: Batey
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001294:Attitude to Health; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D033183:Interdisciplinary Communication; D014761:Viral Hepatitis Vaccines / Q000276:immunology / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014761:Viral Hepatitis Vaccines
references: World J Gastroenterol. 2005 Jul 14;11(26):4085-9
references: 15996035
references: Clin Infect Dis. 2006 Mar 1;42(5):669-72
references: 16447112
references: J Viral Hepat. 2002 May;9(3):235-41
references: 12010513
references: Scand J Gastroenterol. 2005 Jun;40(6):688-96
references: 16036529
references: QJM. 2001 Mar;94(3):153-8
references: 11259690
references: Hepatology. 2001 Jul;34(1):188-93
references: 11431750
references: Addiction. 2004 Sep;99(9):1167-75
references: 15317637
references: South Med J. 2006 Apr;99(4):348-51
references: 16634243
references: J Viral Hepat. 1999 Jan;6(1):35-47
references: 10847128
references: Clin Infect Dis. 2005 Jul 15;41(2):177-86
references: 15983913
references: Aliment Pharmacol Ther. 2006 Nov 1;24(9):1349-57
references: 17059516
references: Sex Health. 2004;1(2):107-13
references: 16334992
references: J Med Chem. 2006 Feb 9;49(3):995-1005
references: 16451065
references: Clin Infect Dis. 2005 Apr 15;40 Suppl 5:S313-20
references: 15768340
references: J Hepatol. 2006 Feb;44(2):275-82
references: 16338019
references: Clin Infect Dis. 2006 Jun 15;42(12):1671-3
references: 16705569
references: Alcohol Clin Exp Res. 2006 Apr;30(4):709-19
references: 16573590
references: Clin Infect Dis. 2006 Jun 15;42(12):1663-70
references: 16705568
references: Dig Dis Sci. 2005 Apr;50(4):714-8
references: 15844707
references: J Gastroenterol Hepatol. 2003 Jul;18(7):841-50
references: 12795758
references: Am J Health Behav. 2005 Sep-Oct;29(5):387-94
references: 16201855
references: World J Gastroenterol. 2006 Sep 14;12(34):5532-5
references: 17006994
references: Curr Opin Microbiol. 2006 Aug;9(4):416-22
references: 16814596
references: J Subst Abuse Treat. 2005 Mar;28(2):181-7
references: 15780548
references: J Clin Virol. 2005 Dec;34 Suppl 2:S69-74
references: 16461243
references: J Clin Virol. 2003 Aug;27(3):276-85
references: 12878092
references: J Gastroenterol Hepatol. 2005 Jan;20(1):79-86
references: 15610451
references: Can J Gastroenterol. 2005 Mar;19(3):153-6
references: 15776135
references: Semin Liver Dis. 2004;24 Suppl 2:97-104
references: 15346252
references: Can J Public Health. 2005 Mar-Apr;96(2):97-101
references: 15850026
references: Hepatology. 1998 Jun;27(6):1730-5
references: 9620350
references: Am J Trop Med Hyg. 2006 Jun;74(6):1111-6
references: 16760529
references: J Viral Hepat. 2005 May;12(3):322-4
references: 15850474
references: Eur Addict Res. 2006;12(3):151-60
references: 16778436
references: J Clin Virol. 2006 Aug;36(4):283-91
references: 16765638
references: Infect Genet Evol. 2007 Jun;7(3):354-60
references: 16720108
references: J Hepatol. 2006 Feb;44(2):422-31
references: 16364492
references: J Gastroenterol Hepatol. 2005 Jul;20(7):1082-6
references: 15955218
references: Pharmacoeconomics. 2006;24(7):661-72
references: 16802842
references: Gastroenterology. 2006 May;130(6):1607-16
references: 16697724
references: Hepatology. 2003 Feb;37(2):443-51
references: 12540795
references: Harm Reduct J. 2006 Sep 06;3:27
references: 16956393
references: Scand J Gastroenterol. 2006 Aug;41(8):969-73
references: 16803696
references: Eur J Epidemiol. 2004;19(12):1119-22
references: 15678792
references: Hepatology. 2005 Oct;42(4):962-73
references: 16149085
references: Drug Alcohol Depend. 2005 Jan 7;77(1):81-6
references: 15607844
references: Clin Infect Dis. 2005 Apr 15;40 Suppl 5:S325-9
references: 15768342
references: J Antimicrob Chemother. 2004 Jan;53(1):15-8
references: 14645325
references: J Infect Dis. 2006 Oct 1;194(7):895-903
references: 16960776
references: Gastroenterology. 2006 May;130(6):1636-42
references: 16697727
references: Ir Med J. 2005 Mar;98(3):73-4
references: 15869062
references: J Clin Forensic Med. 2005 Aug;12(4):196-8
references: 15950514
references: Infect Genet Evol. 2005 Mar;5(2):131-9
references: 15639745
references: J Med Chem. 2006 May 4;49(9):2750-7
references: 16640336
references: Intervirology. 2006;49(1-2):112-8
references: 16166799
references: Aliment Pharmacol Ther. 2006 Oct 1;24(7):1079-86
references: 16984502
references: J Clin Microbiol. 2000 Aug;38(8):2807-13
references: 10921931
references: Gastroenterol Clin North Am. 2006 Jun;35(2):463-86
references: 16880075
references: Hepatology. 2005 Sep;42(3):711-23
references: 16116637
references: Expert Opin Biol Ther. 2006 Sep;6(9):923-33
references: 16918259
references: Semin Thromb Hemost. 2005 Nov;31(5):527-37
references: 16276461
references: J Manag Care Pharm. 2005 Oct;11(8):687-94
references: 16194133
references: Science. 1989 Apr 21;244(4902):359-62
references: 2523562
references: Hepatology. 2002 Nov;36(5 Suppl 1):S210-9
references: 12407596
references: N Engl J Med. 2001 Nov 15;345(20):1452-7
references: 11794193
references: Int J Epidemiol. 2004 Feb;33(1):182-8
references: 15075167
references: Infect Disord Drug Targets. 2006 Mar;6(1):3-16
references: 16787300
references: J Urban Health. 2006 Mar;83(2):275-88
references: 16736376
references: J Med Virol. 2000 Feb;60(2):122-5
references: 10596009
references: Curr Opin Investig Drugs. 2006 Aug;7(8):750-8
references: 16955687
references: J Gen Intern Med. 2003 Oct;18(10):835-44
references: 14521647
references: Drug Alcohol Rev. 1997 Sep;16(3):275-84
references: 16203436
references: J Public Health (Oxf). 2004 Dec;26(4):372-5
references: 15598857
references: Acta Gastroenterol Belg. 2005 Jan-Mar;68(1):55-67
references: 15832589
references: Kathmandu Univ Med J (KUMJ). 2003 Apr-Jun;1(2):101-3
references: 16388206
references: Hepatology. 2006 Jun;43(6):1337-45
references: 16729318
references: Hepatology. 2006 Feb;43(2 Suppl 1):S207-20
references: 16447262
references: J Clin Virol. 2005 Dec;34 Suppl 2:S61-8
references: 16461242
references: J Clin Gastroenterol. 2006 Mar;40(3):220-4
references: 16633123
references: Drug Alcohol Rev. 1997 Dec;16(4):339-47
references: 16203447
references: Harm Reduct J. 2006 Aug 16;3:26
references: 16914042
references: J Gastrointestin Liver Dis. 2006 Jun;15(2):117-24
references: 16802005
references: Public Health. 2005 Dec;119(12):1111-5
references: 16214189
references: J Mol Biol. 2006 Apr 7;357(4):1051-7
references: 16476448
references: Am J Gastroenterol. 2005 Mar;100(3):643-51
references: 15743364
references: Lancet. 1997 Mar 22;349(9055):825-32
references: 9121257
references: Bioorg Med Chem Lett. 2007 Feb 1;17(3):841-5
references: 16990004
references: J Subst Abuse Treat. 2005 Oct;29(3):159-65
references: 16183464
references: Transl Res. 2006 Aug;148(2):79-86
references: 16890148
references: Drug Alcohol Rev. 2003 Sep;22(3):317-21
references: 15385226
references: Curr Opin Drug Discov Devel. 2006 Sep;9(5):618-26
references: 17002222
references: Med J Aust. 1997 Feb 3;166(3):116
references: 9059429
references: Gut. 2003 Oct;52(10):1500-4
references: 12970145
references: Hepatology. 2006 Sep;44(3):703-12
references: 16941700
references: Addiction. 2006 Oct;101(10):1499-508
references: 16968352
references: BMC Public Health. 2006 Jun 27;6:170
references: 16803622
references: Health Hum Rights. 1997;2(2):87-97
references: 11657278
references: BMC Infect Dis. 2006 Jun 08;6:93
references: 16762050
references: Clin Infect Dis. 2005 Apr 15;40 Suppl 5:S330-5
references: 15768343
references: Hepatology. 2004 May;39(5):1213-9
references: 15122749
references: Dig Dis Sci. 2006 Sep;51(9):1619-26
references: 16927136
references: J Med Virol. 2001 Nov;65(3):517-24
references: 11596087
references: Am J Gastroenterol. 1996 Jul;91(7):1374-9
references: 8677998
references: Hepatology. 2006 Sep;44(3):521-6
references: 16941687
references: Drug Alcohol Rev. 2004 Sep;23(3):261-72
references: 15370005
references: Hepatology. 2006 Sep;44(3):527-35
references: 16941688
references: Addiction. 2003 Feb;98(2):153-8
references: 12534419
references: Biochem Pharmacol. 2006 Nov 30;72(11):1477-84
references: 16876765
references: Ann Intern Med. 2006 May 16;144(10):762-9
references: 16702592
references: Gut. 2005 Oct;54(10):1468-72
references: 16162952
references: Clin Gastroenterol Hepatol. 2005 Oct;3(10):937-44
references: 16234037
references: J Subst Abuse Treat. 2006 Jun;30(4):315-21
references: 16716846
references: J Mol Biol. 2006 Aug 4;361(1):33-45
references: 16828488
references: Liver. 2002 Apr;22(2):136-44
references: 12028408
references: Acta Clin Belg. 2001 Jul-Aug;56(4):220-4
references: 11603251
references: J Clin Microbiol. 2003 Apr;41(4):1558-64
references: 12682145
references: Presse Med. 2006 Sep;35(9 Pt 1):1249-54
references: 16969313
references: Gastroenterology. 2006 Mar;130(3):632-8
references: 16530503
references: Addiction. 2006 Feb;101(2):252-66
references: 16445554
references: J Gen Virol. 1993 Nov;74 ( Pt 11):2391-9
references: 8245854
references: Alcohol Alcohol. 2006 Sep-Oct;41(5):546-52
references: 16855001
references: Hepatology. 2003 Jul;38(1):57-65
references: 12829987