Treatment of hepatitis C in patients who have decompensated cirrhosis.

In 1999, the World Health Organization reported that there were 169.7 million cases of hepatitis C virus (HCV) infection worldwide. There are 212,500 Americans with chronic hepatitis C and cirrhosis, and this number will increase to 375,000 by the year 2015. If one applies the United States rates for proportion of HCV RNA positivity, duration of infection, and time required for development of cirrhosis to the world's population of individuals with HCV, then 7.8 million currently have cirrhosis. By 2015, there will be 13.8 million cases of cirrhosis due to HCV. Management of cirrhosis due to hepatitis C will continue to be a major issue for the foreseeable future for hepatologists, gastroenterologists, and primary care providers throughout the world. This article discusses the current status of antiviral strategies in treating patients who have decompensated chronic hepatitis C before transplantation.