Pegylated interferon and ribavirin treatment for hepatitis C virus infection

In patients affected by chronic hepatitis C (CHC) infection, viral eradication can be achieved by antiviral therapy based on the use of a combination of pegylated interferon α-2a or 2b and ribavirin that yields a sustained eradication in 40-50% of cases. The aim of this review is to evaluate the efficacy of pegylated interferon α-2a or α-2b plus ribavirin in the treatment of CHC infection. Treatment must be started in patients with detectable serum hepatitis C virus (HCV) RNA independently by serum alanine aminotransferase levels. In patients infected with genotype 1 or 4 HCV before treatment, a histological evaluation is required. These patients can be treated if stage is ≥2 according to the Knodell index. The treatment must be for 1 year duration and current guidelines allow treatment to be continued if patients remain HCV RNA positive at week 12 if a 2-log drop in viral load has been achieved. In patients with genotype 2 or 3 HCV, therapy must be prolonged for 6 months and histological evaluation pretreatment is not necessary.