Peginterferon and ribavirin for hepatitis C [6]

Foreword This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the authors' clinical recommendations. A 44-year-old woman with chronic hepatitis C has intermittent fatigue and persistent elevations in serum alanine aminotransferase levels. She has had hepatitis C for 10 years. The diagnosis was made after she attempted to donate blood and was found to have antibodies against the hepatitis C virus (HCV). On questioning, she reports having used illicit injection drugs in her early 20s. The physical examination is normal except for obesity. The results of laboratory tests show an alanine aminotransferase level of 86 U per liter (normal value,