Review
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 21, 2008; 14(43): 6627-6631
Published online Nov 21, 2008. doi: 10.3748/wjg.14.6627
Is pegylated interferon superior to interferon, with ribavarin, in chronic hepatitis C genotypes 2/3?
Ijaz S Jamall, Shafaq Yusuf, Maimoona Azhar, Selene Jamall
Ijaz S Jamall, Risk-Based Decisions, Inc., 2033 Howe Avenue, Suite 240, Sacramento, California 95825, United States
Shafaq Yusuf, Maimoona Azhar, Dow Medical College and Civil Hospital, Karachi, 74000, Pakistan
Selene Jamall, University of California-San Diego, La Jolla, CA 92092, United States
Author contributions: Jamall IS developed the approach and hypothesis and wrote much of the initial draft; Yusuf S and Azhar M provided clinical experience and relevance; Jamall S was a student intern with RBDI who conducted the literature search, data evaluation and helped in the writing of the final manuscript.
Supported by Risk-Based Decisions, Inc
Correspondence to: Ijaz S Jamall, Risk-Based Decisions, Inc., 2033 Howe Avenue, Suite 240, Sacramento, California 95825, United States. ijamall@riskbaseddecisions.com
Telephone: 001-916-923-0570 Fax: 001-916-923-0611
Received: August 5, 2008
Revised: November 12, 2008
Accepted: November 19, 2008
Published online: November 21, 2008
Abstract

Over the past decade, significant improvements have been made in the treatment of chronic hepatitis C (CHC), especially with the introduction of combined therapy using both interferon and ribavarin. The optimal dose and duration of treatment is still a matter of debate and, importantly, the efficacy of this combined treatment varies with the viral genotype responsible for infection. In general, patients infected with viral genotypes 2 or 3 more readily achieve a sustained viral response than those infected with viral genotype 1. The introduction of a pegylated version of interferon in the past decade has produced better clinical outcomes in patients infected with viral genotype 1. However, the published literature shows no improvement in clinical outcomes in patients infected with viral genotypes 2 or 3 when they are treated with pegylated interferon as opposed to non-pegylated interferon, both given in combination with ribavarin. This is significant because the cost of a 24-wk treatment with pegylated interferon in less-developed countries is between six and 30 times greater than that of treatment with interferon. Thus, clinicians need to carefully consider the cost-versus-benefit of using pegylated interferon to treat CHC, particularly when there is no evidence for clinically measurable benefits in patients with genotypes 2 and 3 infections.

Keywords: Hepatitis C, Genotypes, Interferon