SUMMARY:
In the Czech Republic the prevalence of hepatitis C virus (HCV) infectios is 0,2%. Approximately 180-200 million people are infected in the whole world. The standard procedure in cases of HCV infections indicated for antiviral therapy is a combination of the so called pegylated interferon alpha (PEG-IFN) and of the virostatic ribavirin (RBV). Depending on the parameters found prior to the onset of treatment (especially the genotype and HCV viraemia) therapy is indicated for a period of 24 to 48 weeks. These virological parameters and the extent of liver involvement are the most important factors helping predict the effect of treatment. The sustained virological response (SVR), considered as the criterion of cured infection, is achieved with the combined PEG-IFN + RBV therapy in some 50 % of the cases. This antiviral therapy may be burdened with many adverse side-effects of varying severity and thus cannot be applied as standard treatment in all cases of HCV infection. Moreover, the price of these preparations is by no means a negligeable element. It has been clearly proved that with standard, accurately defined procedures elaborated using "evidence based medicine" methods, antiviral treatment is in all respects preferable to the treatment of patients with an advanced liver disease. The standard diagnostic and therapeutic procedurepresented in the article has been jointly elaborated by representatives of working parties for viral hepatitis of the Czech Hepatological Society and the Czech Infectious Disease Society in line with the most up-to-date recommendations of several international specialized societies. Attention focuses not only on typical uncomplicated cases of HCV infections, but also on procedures in cases of advanced liver disorders of the liver cirrhosis type. A special chapter is devoted to patients presenting a HCV/HIV co-infection, patients with varying degrees of renal insufficiency, with a permanently normal ALT activity and with some extrahepatic manifestations of HCV infection.