Combination therapy with interferon-alpha and ribavirin for hepatitis C: practical treatment issues

BioDrugs. 2001;15(4):225-38. doi: 10.2165/00063030-200115040-00003.

Abstract

Combination therapy with ribavirin and interferon (IFN)-alpha for 6 to 12 months is currently the treatment of choice for chronic hepatitis C infection. The overall sustained response rate to treatment, defined as loss of hepatitis C virus (HCV) from serum 6 months after completion of treatment, is 40%. The indications for treatment are serum HCV RNA positivity, abnormal serum transaminases and the presence of portal fibrosis and/or moderate/severe inflammation. Response rates are lower in genotype 1 than in genotype 2 or 3 and in the presence of a high viral load. Anaemia is the most common adverse event and is due to ribavirin; neuropsychiatric adverse effects due to IFNalpha lead to premature cessation of therapy in 10 to 20% of patients. The current recommended dose of interferon is 3MU given subcutaneously 3 times a week. However, it is likely that longer-acting pegylated interferons, which may be more effective and can be administered once weekly, will in the future replace currently used IFNalpha.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Drug Monitoring / methods
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / pathology
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / pathology
  • Male
  • Polyethylene Glycols / therapeutic use
  • RNA / blood
  • Recombinant Proteins
  • Ribavirin / therapeutic use*

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • RNA
  • peginterferon alfa-2a