From The New England Journal of Medicine
Hepatitis C virus (HCV) infection is a major health problem worldwide. About 100 million to 150 million people are infected, including approximately 4 million to 5 million in western Europe and 3 million to 4 million in the United States. Approximately 60 to 70 percent of those infected have chronic hepatitis, and 15 to 20 percent have cirrhosis, which may evolve into hepatocellular carcinoma. Although disease caused by HCV infection progresses slowly and usually takes more than 20 to 30 years to develop into clinically overt liver disease, the number of cases is expected to increase sharply during the next decade. In the Western world, HCV infection is the most common cause of liver disease and the main indication for liver transplantation necessitated by end-stage liver disease.
The identification of HCV in 1989 through the use of molecular-biology techniques was an enormous step forward. Still, many issues remain unresolved. An efficient tissue-culture system, which would allow in vitro testing of new and better antiviral compounds, is still lacking. A better treatment for chronic HCV infection is urgently needed, since less than 40 percent of patients have a response to combination therapy with interferon and ribavirin. A vaccine that would prevent and thus stop the spread of the disease is not on the horizon.
With so many challenges, it should not come as a surprise that an enormous amount has been written on the subject of HCV. In the first nine months of this year, 1437 new references were indexed in Medline, nearly three times as many as those devoted to colon cancer and nearly as many as the references on lung cancer. It seems clear from these figures that a comprehensive and up-to-date book on HCV would be useful not only for clinicians and researchers interested in the subject, but also for specialists involved in patient care. Hepatitis C, which includes a tribute to the late Hyman J. Zimmerman, one of the founding fathers of modern hepatology, fulfills these needs.
The book is divided into 25 chapters written by 44 authors, 36 from the United States and 8 from Europe. Three of the chapters deal with viral replication and molecular biology, five with clinical aspects (acute hepatitis, natural history, cirrhosis, cancer, and liver transplantation), two with epidemiology and prevention, three with pathology and cellular and humoral immune responses and with liver-cell injury, four with antiviral therapy and vaccine development, and eight with HCV and its extrahepatic manifestations (such as mixed cryoglobulinemia, renal disease, porphyria cutanea tarda, and iron overload) and with HCV infection in special groups (children, pregnant women, and those with human immunodeficiency virus infection).
I found the chapters on the molecular biology of the virus to be especially interesting, particularly the first chapter, which very clearly summarizes current knowledge of viral structure and genomic organization. The second chapter deals with viral markers and quasispecies and includes practical information on the sensitivity of the various quantitative techniques for measuring viral RNA that are used in predicting responses to antiviral therapy and monitoring its effects. Also excellent are the chapters on pathology, immunopathogenesis, and cirrhosis and HCV. In addition, there is a well-written chapter on the use of complementary and alternative medicine in HCV infection. All chapters include good diagrams and tables, and the references were published as recently as December 1999.
In summary, this book is an outstanding contribution to the challenging field of HCV infection. The editors have succeeded in their goal to "illustrate that the marriage between basic science and clinical medicine is paramount in our ultimate success of controlling this global health problem."
Jaime Guardia, M.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
"The information provided in this book is a valuable update on the rapidly expanding body of knowledge related to HCV based upon basic and clinical research and would be a valuable addition to the library of individuals in hepatitis C research."
-Betty Robertson, Centers for Disease Control and Prevention for VIRUS RESEARCH (March 2002)
"...this volume is truly deserving of the cliche 'state-of-the-art'. ...the book is encyclopedic in its coverage of all angles of HCV infection, and yet is readable, understandable to the non-expert. ...I believe that this will prove to be a valuable reference text for some years to come."
-W. Irving for JOURNAL OF MEDICAL MICROBIOLOGY (April 2002)
"...an excellent book that details the evolution of hepatitis C from discovery to the present and reflects the "state of the art." A key strength of the book is that each of its 25 chapters is written by a leading expert who has spearheaded research in a particular area from its infancy to the present. ...compiles the most important and relevant information on HCV in one readable reference volume. ...an excellent addition to the personal library of anyone who is working in this area."
-Mary Pat Pauly in PRACTICAL GASTROENTEROLOGY (September 2001)
"an outstanding contribution to the challenging field of HCV [Hepatitis C Virus] infection. The editors have succeeded in their goal to 'illustrate that the marriage between basic science and clinical medicine is paramount in our ultimate success of controlling this global health problem."
-NEW ENGLAND JOURNAL OF MEDICINE (December 2000)
