Guidelines for stopping therapy in chronic hepatitis C

Tremendous progress has been made in the treatment of chronic hepatitis C. Over 50% of patients treated with pegylated interferon and ribavirin experience permanent eradication of the hepatitis C virus. The indications for therapy have been expanded based on evolving data concerning the safety and efficacy of these agents. Although awareness of which patients in whom to initiate therapy is important, a thorough understanding of features of the antiviral response is also necessary so that treatment can be discontinued when the chances of sustained response are nil. Recent studies have defined virologic milestones that are useful for managing patients during antiviral therapy. Pretreatment genotype and response to therapy measured at weeks 12 and 24 of treatment have been identified as key determinants in decisions about continuing treatment. Progress in defining early treatment stopping points has reduced adverse events in patients who are unlikely to respond to therapy.