Ureteral decompression in advanced nonurologic malignancies

Development of screening tests for hepatitis C virus (HCV) has enabled study to ascertain hypotheses concerning the epidemiology of non-A, non-B hepatitis. Phylogenic analysis shows that HCV genotypes 1, 2, and 3 are responsible for most cases of chronic hepatitis C in developing countries whereas genotypes 4, 5, and 6 are involved in other areas of the world. Our understanding of the transmission of this virus is also improving and transfusion and addiction-related transmission have now been confirmed. However many questions remain about other routes involving sex, intrafamilial contact, and mother-to-infant transmission. After transfusion there is a period of serological latency during which infection cannot be detected by PCR and which raises the problem of post-transfusion seronegative hepatitis. Current knowledge of the natural history of the disease is limited to the chronic hepatitis stage. New methods must be developed to detect and study the disease in cohorts with early stage disease. Since knowledge about worldwide prevalence is also limited, further studies are needed in the general population in different geographical areas taking into account the fact that southern and eastern Europe, Japan, and Black Africa are high prevalence zones with rates above 1.5%.