Pegylated Interferon-A Plus Ribavirin
A combination of standard interferon-

-2b and ribavirin is currently recommended as the treatment of choice for patients with hepatitis C virus (HCV) infection considered to be at greatest risk of disease progression (those with moderate to severe fibrosis and/or inflammation and those with compensated cirrhosis). This combination increases the sustained response rate (no detectable HCV RNA 6 months after completion of treatment) compared with interferon-

monotherapy in both previously untreated patients and those who have relapsed following a previous course of interferon-

therapy. Treatment duration (24 or 48 weeks) depends on the presence or absence of a number of favourable prognostic factors.

A pegylated formulation of interferon-

-2b in combination with ribavirin looks likely to supersede standard interferon-

-2b/ribavirin combination therapy following recent approvals in Europe and the US. The pegylated interferon-

-2b formulation increases the half-life of interferon-

and has the advantage of less frequent administration. In previously untreated patients, the pegylated interferon-

-2b/ribavirin combination showed a greater sustained response rates than standard interferon-

-2b/ribavirin in a large randomised trial. Planned and ongoing studies should help to define the optimum use of this combination and whether this combination can be used to treat patients who failed to respond or relapsed following other interferon-

treatment regimens.