Chronic hepatitis C and normal ALT: considerations for treatment.

Improvements in the treatment of patients with chronic hepatitis C have progressed over the past 14 yr. Initially, treatment of patients with persistently normal ALT levels was not considered necessary. As treatment response improved, more of these patients were treated. Jacobson and colleagues have shown that patients with normal ALT levels respond similarly to those with elevated ALT levels when treated with the combination of interferon and ribavirin. ALT levels are a poor marker of disease severity and/or indication for treatment in patients with chronic hepatitis C.