Combination therapy with interferon plus ribavirin for the initial treatment of chronic hepatitis C

The limited efficacy of alpha interferon (IFN) monotherapy for hepatitis C virus (HCV) infection has led to the investigation of alternative treatment approaches, including combining interferons with other antiviral agents. lit several small, pilot studies, the combination of IFN plus ribavirin was significantly more effective than IFN monotherapy for the initial treatment of HCV The encouraging results from these studies provided the rationale for. conclusions two tone US, one (International) large, multicenter; randomized, placebo-controlled clinical trials of IFN plus ribavirin therapy for the initial treatment of HCV patients. Of patients receiving combination therapy for 24 weeks, 31% (US) and 35% (International) achieved sustained virologic remission, compared with only 6% (US) of patients receiving IFN plus placebo. Sustained virologic response rates were improved in patients treated with the combination for 48 weeks (51% versus 21% for IFN alone). Improvement was also observed in ter ms of biochemical and histologic end points in those receiving combination therapy. Pretreatment variables (HCV genotype, viral burden, stage of fibrosis) were less important as predictors of treatment outcome in patients receiving combination therapy. The safety profile of combination therapy reflected the individual safety profiles of IFN and ribavirin, without synergism. Combination therapy with IFN plus ribavirin was more effective than IFN monotherapy for the initial treatment of HCV in terms of virologic, biochemical, ann histologic end points. The combination appears to be well tolerated with a predictable safety profile.