This prospective, multicentre study was conducted during 2–30 April 2001 in the internal medicine/infectious diseases services in France and included data from 1858 hepatitis C virus (HCV)-infected patients, half of whom were HIV co-infected. The aims were to outline the type of pre-therapeutic evaluation of HCV infection performed (HCV RNA, genotype, liver biopsy); determine the proportion and characteristics of patients receiving antiviral treatment; and determine if any changes in these parameters had occurred between 1995 and 2001. Patients whom had a complete pre-therapeutic evaluation (39%, 709/1834) and received antiviral treatment (38%, 690/1830) were more likely to have abnormal liver biochemistry, cirrhosis and cryoglobulinaemia (P<0·001). Injecting drug users and HIV-co-infected patients were less likely to have a complete pre-therapeutic evaluation or receive antiviral treatment (P<0·001). A complete pre-therapeutic evaluation was more often performed in 2001 than in 1995 (39% vs. 6%, P<0·001), including qualitative HCV RNA testing (91% vs. 68%, P<0·001), genotyping (59% vs. 7%, P<0·001) and a liver biopsy (60% vs. 29%, P<0·001). The frequency of anti-HCV treatment approximately doubled between 1995 and 2001 (20% vs. 38%, P<0·001). Although adherence to consensus recommendations regarding pre-therapeutic evaluation is not ideal, a substantial improvement has occurred since 1995. Nevertheless, means of increasing the availability of antiviral therapies, particularly for patients with HIV co-infection or injecting drug use, require further study.