Recommended Therapy
Chronic HCV infection is a curable disease and eradication of HCV improves outcome, especially in patients with HCV-related extensive fibrosis or cirrhosis.^2–4 The currently recommended therapy for chronic HCV is a combination of pegylated interferon (PEG-IFN) and ribavirin (RBV) for 24–48 weeks, depending on the viral genotype and the immunological status of the patient. Two forms of PEG-IFN, α-2a (40kDa) (Roche Pharmaceuticals, Basel, Switzerland) and α-2b (12kDa) (Schering Plough, Kenilworth, New Jersey, US), have been approved for HCV treatment. Although they differ in their pharmacological properties, both possess an increased and sustained duration of activity due to a longer serum half-life compared with conventional IFN-α.^5–7 PEG-IFN-α-2b has a larger volume of distribution and faster clearance than PEG-IFN-α-2a; plasma levels are dependent on bodyweight.^5,7 For this reason, PEG-IFN-α-2b is administered at a dose of 1.5μg/kg subcutaneously once weekly. PEG-IFN-α-2a is given at a fixed dose of 180μg subcutaneously once weekly. In patients infected with genotypes 1 or 4 (so-called ‘difficult-to-treat patients’), RBV is given at high doses (1,000–1,200mg per day according to bodyweight ≥13.5mg/kg/day). For patients infected with genotypes 2 or 3 (so-called ‘easy-to-treat patients’), RBV is given at low doses (800mg/day).⁸

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