Different approaches have been taken to improve the response rate. Several randomized trials have clearly proven that extension of interferon therapy for at least 12 months achieves a higher sustained response rate. Daily administration of interferon at higher doses may constitute another strategy and different trials are going on.
Ribavirin is a nucleoside analogue that inhibits the replication of many different viruses.
Pilot studies found that the combination therapy with interferon and ribavirin increased the sustained response rate compared to the monotherapy. Brillanti in Europe and Kakumu in Japan showed beneficial effects of the combination therapy in non responders and naive patients. Dr Lai, et al in Taiwan treated 60 patients comparing interferon alone versus combination therapy during 6 months. There is an ongoing international clinical trial comparing the efficacy of combination therapy with interferon alfa plus ribavirin during 24 or 48 weeks versus interferon alfa alone during 48 weeks in naive patients. The results of this trial will provide important information for the treatment of naive patients.