Based on recent data, previously untreated patients with HCV infection are most likely to achieve a sustained virologic response with interferon plus ribavirin than they are with interferon alone.
Ribavirin is a synthetic guanosine analogue.
The exact mechanism of action has not been established but may involve anti-viral and immunomodulatory actions. Ribavirin, when given alone, decreases ALT levels transiently, but has no anti-viral effect. To date, five randomized, controlled trials of interferon plus ribavirin as initial treatment for chronic HCV infection have been published. All have demonstrated that the combination of interferon plus ribavirin significantly increases sustained loss of HCV RNA posttreatment compared with interferon alone. In these studies, the proportion of patients with genotype 1 infection was generally lower than in the United States.