Patients diagnosed with HCV should have serum liver function tests and get a baseline HCV RNA level (viral load), since treatment decisions are affected by these laboratory values. Genotype testing is indicated for treatment decisions and prognosis. Therapy with interferon and ribavirin (dual therapy) has been shown in randomized placebo-controlled trials to lead to sustained viral response in 30% to 50% of patients compared with 6% to 21% with PEG-interferon alpha-2b (Viraferson PEG) therapy only. Genotype 1 should be treated with dual therapy for 48 weeks and all other types treated for 24 weeks. Evidence is lacking on the optimum monitoring approach for patients taking dual therapy; consensus recommendations are given in the TABLE 1. Recent evidence shows that treatment with PEG-interferon alpha-2b and ribavirin with weight-based dosing achieved an 82% sustained viral response. (Grade of recommendation: A [dual therapy]; D [all other recommendations].
