Valuable overview of hep C

This book is an excellent resource for healthcare professionals who work with hepatitis C, and for people suffering from this condition who wish to have access to detailed, up-to-date, technical information. The book is multi-authored and its main strength is its well-chosen authors — they are all Australian experts. Scott Bowden (Senior Scientist at the Victorian Infectious Diseases Reference Laboratory) has written a comprehensive chapter on laboratory diagnosis. He explains clearly the difficulties in comparing the two assays used for quantifying viral load, and the differences between the various serological assays. William Sievert, of Monash Medical Centre, has contributed an excellent chapter on antiviral treatment, with up-to-date information on newer treatments, and predictors of response.

Margaret MacDonald, Nick Crofts, Alex Wodak and John Kaldor have written the chapter on hepatitis C transmission. Nick Crofts has expanded on transmission in a subsequent chapter entitled “Descriptive epidemiology of the hepatitis C virus”. This chapter provides an interesting and detailed review of global trends in hepatitis C.

As well as technical sections on virology, pathogenesis, treatment and epidemiology, there are excellent sections on quality of life, discrimination, policy and prevention.

There are always areas where an individual reviewer will see omissions. Liver transplantation is not described in any detail — many readers would like to know whether transplantation has a role, and what its success, limitations and implications are. Similarly, there is not much information on “the next ten years” in antiviral treatment.

The chapters on policy and prevention are excellent, but do not address some of the gaps in current policy and practice. For example, the apparent ineffectiveness of harm reduction programs in significantly reducing the prevalence of hepatitis C is not considered, nor are the lack of culturally appropriate education or treatment facilities for ethnic groups and the lack of resources in rural areas.

I hope that the positive foreword written by the former Federal Minister for Health, Dr Michael Wooldridge, indicates an ongoing commitment by government to address some of these issues. It will be interesting to see whether these gaps have been closed by the time a second edition is published in a few years’ time (as I hope it will be).

A manageable size at 350 pages, the book is well referenced, well indexed and, at $85, well worth the price.

Katrina J R WatsonGastroenterologist St Vincent’s Hospital, Fitzroy, VIC