Hepatitis C is a chronic disease with lethal complications and recent treatments have a strong efficacy. Ribavirin and alpha interferon combination allows obtaining a sustained viral response in 40% of patients who are theoretically protected against the progression to cirrhosis and its complications. In non responders prospective trials are in progress assessing the efficacy of stronger regimen or using sustain-release interferons. It is also possible that in non responders interferon reduces the progression of liver fibrosis permitting to reduce cirrhosis incidence and to wait for new drugs. Patients who need definitively a treatment are patients with fibrosis progression, patients with extrahepatic manifestations and those who can transmit the virus. Treatment of HCV should be systematically discussed in patients coinfected with HIV and HCV.