Viral hepatitis C, referred to as hepatitis C and hepatitis C, is a viral hepatitis caused by hepatitis C virus (HCV) infection, which is mainly transmitted through blood transfusion, needle stick and drug use, and some patients can develop cirrhosis or even liver cancer. At present, the global HCV infection is about 1, 600 million, which leads to 250,000 deaths every year. China’s epidemiological survey data show that there are about 40 million hepatitis C patients, with a population hepatitis C infection rate of 3.2% and more than 100,000 new cases each year. Because hepatitis C is mostly insidious and almost asymptomatic, it is not as “high profile” as hepatitis B. A survey on hepatitis C awareness initiated by the China Hepatitis Prevention and Control Foundation in 2007 showed that only 1% of people had correct knowledge of hepatitis C transmission routes and preventive measures; only 5% of respondents had been screened for hepatitis C virus. Only 5% of the respondents had been screened for hepatitis C virus. To help readers understand hepatitis C, this article will introduce common misconceptions about hepatitis C, clinical diagnosis methods and the latest treatment progress. 1. Hepatitis C: a hidden killer of the liver. After HCV infection, patients usually do not show any symptoms. And the degree of chronicity is very high, less than 20% of patients can spontaneously clear the virus. Without treatment, most patients will have HCV in their bodies for life. Chronic hepatitis C progresses silently and slowly, with cirrhosis developing in about 10-20% of patients within 20 years. Once it progresses to cirrhosis, the 5-year survival rate for patients drops to 50%, meaning that half of all patients will die every 5 years due to cirrhosis of hepatitis C. The annual incidence of liver cancer in patients with cirrhosis is also as high as 1-4%, which means that 1-4 out of every 100 patients with cirrhosis will develop liver cancer each year. Once hepatitis C patients develop symptoms, they often have progressed to cirrhosis or even liver cancer. Therefore, compared with other causes of hepatitis, hepatitis C should never be detected by symptoms alone, but more emphasis should be placed on early screening. 2. Who needs to be screened for hepatitis C. Hepatitis C is mainly transmitted through blood transfusions, and this route has been effectively controlled in China since 1993 when blood donors were screened for anti-HCV. Transmission via broken skin and mucous membranes has now become the predominant mode of transmission, with intravenous drug use leading to HCV transmission being the most common. The use of non-disposable syringes and needles, dental instruments not strictly sterilized, endoscopy, invasive procedures and needle sticks are also important routes of transmural transmission. Some traditional medical practices that may result in skin breakdown and blood exposure (e.g., acupuncture) have also been associated with HCV transmission; sharing razors, toothbrushes, tattoos, and ear piercing are also potential modes of HCV transmission. The risk of HCV infection is higher for those who have sexual intercourse with an HCV-infected person and for those who have other sexually transmitted diseases, especially those infected with human immunodeficiency virus. Mothers infected with HCV can also transmit it to their newborns during delivery. Therefore, the high-risk groups that need to be screened can be briefly summarized in the table below. 3. The place of pegylated interferon in the treatment of chronic hepatitis C. Prior to the introduction of direct antiviral agents (DAAs) into clinical practice in 2011, pegylated interferon (PEGIFN) in combination with ribavirin was the standard of care for chronic hepatitis C worldwide, a regimen that cured more than 50-60% of hepatitis C patients. PEGIFN remains the cost-effective treatment option in the 2014 World Health Organization (WHO) published Guidelines for Screening, Care and Treatment of Hepatitis C, as well as in the recommendations of hepatitis C guidelines in different countries and regions. 4. New drugs make hepatitis C a “curable disease”. New direct antiviral agents (DAAs) that have recently been marketed in Europe and the United States play a strong role in inhibiting viral replication by directly inhibiting HCV protease, RNA polymerase or other sites of the virus, increasing the cure rate to more than 95% and making hepatitis C a truly curable disease. Moreover, these new drugs have minimal side effects and can also be used for antiviral therapy in patients with hepatitis C cirrhosis. At present, these new anti-HCV drugs have been in China to carry out phase III clinical trials, the official launch is also imminent. 5, hepatitis C patients with normal liver function also need treatment. Because hepatitis C has become a curable disease, there is a wider choice of people to treat, as long as the hepatitis C virus nucleic acid (HCV RNA) test is positive, you need to actively treat. Unlike hepatitis B, so-called “healthy” carriers with normal liver function do not require immediate treatment.