Treatment of hepatitis C virus: the first decade

Interferon alfa therapy emerged as an early treatment option for patients with chronic hepatitis C. This therapy, however, fails to produce a sustained virological response in most patients. Various host and viral baseline characteristics, some of which include hepatitis C virus genotype, viral load, presence of cirrhosis, and patient age, affect the response to interferon therapy. The addition of ribavirin to interferon therapy significantly improves long-term virological response in treatment-naive patients and is also more effective than repeat interferon therapy is in patients who fail to initially achieve sustained virological or biochemical responses. However, ribavirin can induce reversible hemolytic anemia, and combination therapy with a ribavirin/interferon regimen is not tolerated as well as interferon is alone. Pegylated interferons used alone or in combination with ribavirin provide improved treatment options for different patient groups with chronic hepatitis C.