The treatment of chronic hepatitis C has made remarkable progress over the
past two decades. For interferon-alpha monotherapy, sustained virological
response rates were between 2 and 9% in genotype 1 and between 16 and 23%
in genotypes 2 and 3. By adjusting treatment duration up to 48 weeks for
genotype 1 and combining regular interferon-alpha with ribavirin,
sustained response rates could be improved to 28 to 31% in genotype 1 and
around 65% in genotypes 2 and 3. Attempts to further increase efficacy
included the addition of amantadine without conclusive evidence up till
now. With the recent introduction of long-acting pegylated
interferon-alpha in combination with ribavirin, sustained virological
response rates of 8o% can be obtained in genotypes 2 and 3. However,
sustained virological response rates for patients with either genotype 1,
nonresponse to prior treatment, cirrhosis or a combination of these
characteristics are still less than 50%. In view of results with daily
high-dose interferon-alpha induction in combination with prolongation of
treatment duration up to 18 months, such patients might benefit from
induction and prolonged PEG-IFN-alpha treatment and should be treated in
an experimental setting
