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COPYRIGHT 2004 International Medical News Group
Treatment of chronic hepatitis C infection has improved tremendously over the past decade. The current standard of care is a regimen that combines a pegylated, long-acting form of interferon plus the oral antiviral ribavirin.
This combination produces a sustained viral response in about 50% of patients, a jump from the 30% rate when standard interferon was used with ribavirin a few years ago. Some patients treated with this combination have been followed for up to 5 years, have remained free of virus, and are considered essentially cured.
Interferon has direct and indirect antiviral effects; pegylation prolongs its serum half-life. Two formulations of peginterferon-[alpha] are on the U.S. market. The mechanism of ribavirin's effect is not entirely clear, but it definitely improves interferon's efficacy. Ribavirin may have an immunomodulatory effect that enhances a patient's innate antiviral response.
Peginterferon monotherapy is considered for patients who cannot tolerate or take ribavirin, but it is clearly inferior to combination therapy. Ribavirin monotherapy does not eradicate hepatitis C virus and is not often used.
Optimal duration of therapy varies depending on the genotype...
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