TY  - JOUR
A1  - Meer, Adriaan J. van der
A1  - Wedemeyer, Heiner
A1  - Feld, Jordan J.
A1  - Hansen, Bettina E.
A1  - Manns, Michael P.
A1  - Zeuzem, Stefan
A1  - Janssen, Harry L. A.
T1  - Is there sufficient evidence to recommend antiviral therapy in hepatitis C?
T2  - Journal of hepatology
N2  - While patients with chronic hepatitis C virus (HCV) infection are treated in order to prevent liver-related morbidity and mortality, we rely on sustained virological response (SVR) as a virological biomarker to evaluate treatment efficacy in both clinical practice as well as in drug development. However, conclusive evidence for the clinical benefit of antiviral therapy or validity of SVR as surrogate marker, as derived from trials randomizing patients to a treatment or control arm, is lacking. In fact, the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis (HALT-C) trial recently showed an increased mortality rate among interferon-treated patients compared to untreated controls. Consequently, the recommendation to treat patients with chronic HCV infection was challenged.
Here, we argue that the possible harmful effect of long-term low-dose pegylated interferon mono therapy, as was observed in the HALT-C trial cohort, cannot be extrapolated to potentially curative short-term treatment regimens. Furthermore, we discuss SVR as a surrogate biomarker, based on numerous studies which indicated an association between SVR and improvements in health-related quality of life, hepatic inflammation and fibrosis, and portal pressure as well as a reduced risk for hepatocellular carcinoma (HCC), liver failure and mortality.
KW  - Chronic hepatitis C
KW  - Antiviral therapy
KW  - Clinical efficacy
KW  - Mortality
Y1  - 2014
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/77045
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-770459
SN  - 0168-8278
VL  - 60
IS  - 1
SP  - 191
EP  - 196
PB  - Elsevier
CY  - Amsterdam
ER  -