Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: Dr Menkes raises 2 issues not addressed
in our study. The first concerns the correlation between the decrease in viral
load and an attenuation of extrahepatic manifestations of HCV infection. This
issue was beyond the scope of our trial, and the patients were not screened
for cryoglobulinemia or rheumatoid factor. However, it is noteworthy that
clinical extrahepatic manifestations of HCV infection were rare in our study
participants (one patient had vasculitis and another had polyneuritis). This
was probably due to the exclusion of patients with antinuclear antibodies
at baseline. In previous studies of HIV-seronegative populations, we found
that an HCV virological response was associated with a reduction in cryoglobulin
levels and with an improvement in clinical extrahepatic manifestations.1- 4 The question
of such an association remains open in the HIV-coinfected population.
Carrat F, Bani-Sadr F, Cacoub P, Pol S, Perronne C, ANRS HC02-RIBAVIC Study Team FT. Pegylated Interferon vs Standard Interferon for Chronic Hepatitis C—Reply. JAMA. 2005;293(11):1323-1324. doi:10.1001/jama.293.11.1323-b