The “silent” epidemic of hepatitis C is no longer silent, thanks to the discovery and molecular cloning of the virus, coupled with the development and deployment of assays that specifically detect anti-HCV and HCV RNA in infected patients. These combined approaches have reduced the risk of acquiring HCV from contaminated blood to almost zero. On the clinical level, the challenge is to try to stem the magnitude of the epidemic in the foreseeable future by intensifying community outreach and education programs designed to avoid infection: making the public aware of the remaining major risk factors, including IV drug abuse and the problems of transmission associated with multiple sexual partners. For those already infected, the need for counseling has never been greater, not only for the prevention of transmission but also in making important therapeutic decisions that patients can live with. Fortunately, the use of IFN and ribavirin combination therapy has provided a great deal of hope for chronically infected patients, who otherwise have a very high risk for the development of end-stage liver disease. There is still a long way to go before all patients with chronic HCV infection can be effectively and safely treated. The combination of high throughput screening assays (using individual virus gene products produced by recombinant DNA technology), and the willingness of physicians to introduce some of the best candidates into clinical trials, will invariably lead to an improvement in the therapeutic tools available and the outcome of infection.