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Volume 360:1151-1153 March 12, 2009 Number 11
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Prolonged Therapy for Hepatitis C with Low-Dose Peginterferon

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by Di Bisceglie, A. M.
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To the Editor: Di Bisceglie et al. (Dec. 4 issue)1 report the results of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial. Although antiviral therapy for hepatitis C improves surrogate outcomes (alanine aminotransferase levels, histologic changes, and sustained virologic responses), these surrogates have never been validated.2 In the HALT-C trial, maintenance therapy with peginterferon therapy improved inflammatory markers (alanine aminotransferase levels and necroinflammatory histologic findings) and reduced viral titers (producing more sustained virologic responses) without affecting clinical outcomes.1 This discordance suggests that the surrogate outcomes are not valid.

In most untreated, infected patients, decompensated cirrhosis will never develop.3 . . . [Full Text of this Article]



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