Aims -Our aim was to assess the proportion of patients in a well-defined population reaching specialized medical care after hepatitis C diagnosis. Methods -Hepatitis C-positive patients recorded in the population-based registry of Cte-dOr, an administrative district in France, constituted the study population. Results -Between 1994 and 1999, new hepatitis C-positive serology was diagnosed in 847 patients, of whom 690 were eligible for this study. A total of 135 patients had not been given specialized medical care after diagnosis; among them, 50.4%had a normal serum alanine transferase level at diagnosis, 62.2%had risk factors related to lifestyle (drug addiction, sexual risk...), and 26.7%were current alcoholics. The 555 other patients were involved in specialized medical care after diagnosis: 42.7%had a liver biopsy and 27.0%were treated. Treatment was carried out more often in males than in females (OR: 1.67; P < 0.005), and in patients less than 65 years old (OR: 2.94; P < 0.0002). Nearly 30.5%of patients with a Metavir score greater than A1F1 did not undergo treatment. Conclusion -This study shows that in a general population at least one patient out of five with hepatitis C infection remains outside the health care system. It also reveals that management practices vary with gender. Further surveys are needed to better understand this phenomenon. Aims-Our aim was to assess the proportion of patients in a well-defined population and specialized medical care after hepatitis C diagnosis. Methods-Hepatitis C-positive patients recorded in the population-based registry of Cte-d’Or, an administrative district in France, constituted the study population. Results -Between 1994 and 1999, new hepatitis C-positive serology was diagnosed in 847 patients, of whom 690 were eligible for this study. A total of 135 patients had not been given specialized medical care after diagnosis; among them, 50.4% had a normal serum alanine transferase level at diagnosis, 62.2% had risk factors related to lifestyle (drug addiction, sexual risk ...), and 26.7% were current alcoholics. In particular medical care after diagnosis: 42.7% had a liver biopsy and 27.0% were treated. Treatment was carried out more often in males than in females (OR: 1.67; P <0.005), and in patients less than 65 years old : 2.94; P <0.0 002). Nearly 30.5% of patients with a Metavir score greater than A1F1 did not undergo treatment. Conclusion -This study shows that in a general population at least one patient out of five with hepatitis C infection remains outside the health care system. reveals that management practices vary with gender. Further surveys are needed to better understand this phenomenon.