Chronic viral hepatitis and use of interferon. Whom are we treating?

When the number of Americans carrying hepatitis B or C virus is compared with the number facing end-stage liver disease, it is obvious that most carriers are spared disease progression. Unfortunately, there is no way to identify the few patients who will not be so fortunate. Dr Koretz contends that subjecting all patients to the risks and expense of interferon therapy with the hope that we may help those few is not justified. Improved short- or long-term symptomatology should be the primary objective of therapy, he states, not normalization of laboratory findings, and he notes that available data do not prove that interferon accomplishes this goal.