New Paradigms

Hepatitis C continues to be the dominant concern in hepatology and so it is not surprising that this is the fourth issue of Seminars in Liver Disease since 1995 devoted solely to this topic. In addition, there promises to be more in the future. The 10 articles in this issue of Seminars are divided roughly into two groups, the first focusing on the subject of patient management and treatment, and the second focusing on more basic themes. This issue begins with a series of articles that collectively define new paradigms for the clinical management of hepatitis C virus (HCV)-infected patients. Recently developed treatment protocols and clinical care strategies that promise to broaden the population of patients whose chronic HCV infection can be treated safely and effectively are presented and evaluated. In addition, in separate articles that relate to patient management, the evolving role of the liver biopsy is discussed, and future treatment options are described. The focus then shifts from the care of the patient, to the disease processes taking place in the patient. A new model of HCV pathogenesis is presented, an unconventional portrait of the (very lipid-rich) HCV virion is unveiled, the discovery and analysis of the novel overlapping gene is described, and the implications of possible central nervous system invasion are considered.

The editors are grateful to the authors for their time, patience, and imagination. They created a unique collection of articles, as illustrated by the brief highlights that are presented below.