HEPATITIS C Four million Americans are infected with the Hepatitis C virus (HCV), most of whom do not know they are infected. Risk factors for infection include having received blood or blood products before 1997, having a tattoo, having been on active duty with the US Military, sharing self-injecting intravenous drug apparatus ("rigs"), and having multiple sexual partners. More than 90% of those who become infected remain so, and the chronic hepatitis can lead to liver scarring or cirrhosis, which ultimately can lead to liver failure or liver cancer and death. Unlike Hepatitis A and Hepatitis B, there is no protective vaccine for Hepatitis C. Recent progress in understanding Hepatitis C includes the usefulness of testing all high-risk persons, immunizing all those with chronic Hepatitis C against Hepatitis A & B, and stressing the importance of avoiding use of alcohol to prevent progression to cirrhosis. Unfortunately co-infection or double infection with both HIV an HCV makes HCV progress more rapidly to cirrhosis and liver failure, such that nearly Þ of the deaths currently reported in HIV/AIDS patients are due to liver-related problems, most of which are related to Hepatitis C. Newer effective and safe treatments for Hepatitis C are now available. Our practice site has been selected and participating in a study to determine the safety of a new more effective form of alpha-interferon for Hepatitis C treatment. Enrollment begins in March 2001. The new interferon "PEG-interferon" (PEG stands for Poly-Ethylene Glycol, a molecule attached to the interferon to make it last longer in the body). The study will compare PEG-interferon alone or in combination with Ribaviron, another anti-virus medicine taken orally. PEG-interferon allows once-a-week interferon injections instead of 3-times-a-week as the current FDA approved injectable interferon used to treat HCV infection. Dr. Bodner and Dr. Laya are co-investigators in this study and are both enrolling new patients. Dr. Bodner serves on TennCARE's Hepatitis C committee with public health officials to improve the diagnosis and treatment of Hepatitis C for Tennesseans in general and TennCARE members in particular.