NEW YORK, 26 July (Praxis Press) The long-term viral and clinical patterns of hepatitis C virus (HCV) infection are unknown. Thomas and colleagues studied the incidence and determinants of viral clearance and clinical outcome in patients who acquired HCV by injecting drugs. Viral clearance occurred in about 10% of patients during a median follow-up of 8.8 years; clearance occurred more often in non-black patients and in non-HIV-infected patients. End-stage liver disease (ESLD) occurred in about 2% of patients; ESLD was associated with greater age at baseline and higher weekly alcohol intake. Persistent viremia, in the absence of clinical liver disease, is the typical pattern of HCV infection; viral clearance and ESLD are rarer outcomes.