Peginterferon and ribavirin in HCV: Improvement of sustained viral response

Peginterferon alfa in combination with ribavirin is and will remain for the next years the current standard for treatment of chronic hepatitis C. The new antivirals currently investigated in phase II of III trials may augment the overall response rates but require peginterferon/ribavirin as backbone. The cure rate of peginterferon/ribavirin treatment can be improved by better education of treating physicians to identify and treat conditions which negatively influence the final outcome of therapy. Specific focus is the prevention and/or early treatment of common side effects of therapy including anaemia, cytopenia and depression. In selected patients increasing the dose of peginterferon and/or ribavirin may augment response rates. Measuring the viral response at various time points during treatment allows individualization of treatment duration. Treatment duration may be shortened in patients with undetectable HCV-RNA after 4 weeks of therapy, on the other hand slow virologic responders may benefit from prolonged treatment.