Goals of Antiviral Therapy: Viral Clearance or ALT Normalization

  • Solko W. Schalm
  • Tekla G. J. van Rossum
Conference paper


The generally accepted goal of antiviral therapy in chronic hepatitis B is HBeAg-seroconversion [1]; this outcome measure is associated with a persistent decrease in viral replication, biochemical inactiva tion of the liver disease, and prolonged survival [2, 3]. For chronic hepatitis C, the outcome measure that is accepted as clinically relevant is sustained biochemical inactivation of the liver disease (normal alarine aminotransferase (ALT) 6–12 months after the end of therapy) [4, 5]. Although this endpoint is highly correlated with undetectable viral replication, histological remission of the disease, and persistence of biochemical and virological remission [6–8], the trend in trials and practice is to change to the outcome measure of HCV RNA negativity [9, 10]. Similarly, in chronic hepatitis B, the outcome measure of HBV DNA negativity is gaining increased acceptance, especially in assessing the effect of new nucleoside analogues [11–13].


Chronic Hepatitis Antiviral Therapy Viral Clearance HBeAg Loss Sustained Responder 
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Copyright information

© Springer Japan 1999

Authors and Affiliations

  • Solko W. Schalm
    • 1
  • Tekla G. J. van Rossum
    • 1
  1. 1.Department of HepatogastroenterologyErasmus University Hospital, DijkzigtRotterdamThe Netherlands

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