Recent advances in the management of hepatitis C virus (HCV) infection have improved the response to therapy. Predictors of a favorable response include infection with HCV genotype 2 or 3 (rather than genotype 1), low viral load, no fibrosis or only portal fibrosis, and age less than 40 years. Liver biopsy remains the best method of assessing disease severity. Therapy is strongly recommended for patients with aggressive disease, such as stage 2 to 4 fibrosis, although all infected patients should be considered potential candidates for therapy. Pegylated interferon alfa in combination with ribavirin is currently the treatment of choice for patients with newly diagnosed HCV infection. This regimen results in a sustained viral response in more than half of patients treated.