Combination therapy with IFN plus ribavirin, a nucleoside analogue, was most promising. It also decreased the number of patients who suffered relapse at treatment end. Genotypes 2 and 3 responded well to combination therapy, and although there was only a 17 per cent response rate amongst patients with HCV genotype 1, this was a vast improvement on the two per cent measured with IFN monotherapy. Side effects are an issue for both IFN and ribavirin. The psychological effects of IFN are well known, and ribavirin produces dose dependent haemolysis, which can be dangerous in coronary artery and cerebrovascular disease.
Ribavirin is also teratogenic and is contraindicated in renal failure.
Despite all these problems, this combination treatment with IFN and ribavirin probably represent the best future treatment.