The current recommendations for therapy of chronic hepatitis C are a 6
-month course of alpha-interferon in doses of 3 million units 3 times
weekly. Patients should have compensated chronic liver disease with el
evations in serum aminotransferases, serologic evidence of hepatitis C
virus (HCV) infection and chronic hepatitis by liver biopsy. At prese
nt, a long-term beneficial response to alpha-interferon occurs in only
10-25% of patients. The modest long-term response rate and the restri
cted recommendations for use of interferon leave several unresolved is
sues regarding therapy of this disease. Do patients with atypical, sev
ere or advanced disease warrant therapy? What is the optimal dose and
duration of treatment? How can one increase the response rate to inter
feron? How can one predict which patients are likely to benefit from t
herapy? Which patients are likely to relapse if therapy is stopped? Ul
timately, what is needed to answer these issues are better techniques
to assess HCV infection and monitor therapy as well as more effective
and better-tolerated agents that can be used alone or in combination w
ith alpha-interferon.