Most people infected with hepatitis C virus (HCV) develop a chronic infection with persistent viraemia and are at risk of progressive liver damage. However, the outcome of chronic HCV infection is extremely variable and is influenced by many factors, including HCV genotype, HCV viral load, route of infection, age at infection, sex, and alcohol consumption. Ultimately, it is the progression to cirrhosis that is the key determinant of both morbidity and mortality¹ and a better understanding of additional influences likely to promote this development is needed.

Both hepatitis B virus (HBV) and HCV are transmitted parenterally and coinfection is not uncommon, particularly in intravenous drug users and in countries with a high prevalence of HBV infection.² Coinfection with evidence of chronic HBV and HCV seems to result in more severe liver disease than either infection alone,³ with an increased risk of liver cancer² and probably an increased risk of fulminant . . . [Full text of this article]