Peginterferon Alfa-2B versus peginterferon Alfa-2A with ribavirin for the treatment of chronic hepatitis C: the pursuit of an ideal.

摘要

Treatment of chronic hepatitis C is aimed at persistent eradication of hepatitis C virus (HCV), an end point that can drastically modify the natural progressive course of the disease (Hepatology 2002;36:S35-S46). Indeed, once achieved, a sustained virologic response (SVR) can benefit both the patients with chronic hepatitis, by preventing progression to cirrhosis (Gastroenterology2002;122:1303-1313), as those with established cirrhosis as it can reduce the risk of hepatic decompensation and hepatocellular carcinoma (Hepatology 2007;45:579-587). The latest innovation in anti-HCV treatment has been the development of pegylated interferon (PegIFN) through the attachment of 1 or more polyethylene glycols to the IFN molecule (Hepatology 2006;43[Suppl l]:S207-S220), a process that drastically modifies the immunologic, phar-macokinetic, and pharmacodynamic properties of the drug (Clin Pharmacokinet 2001;40:539-551). However, the development of 2 forms of PeglFN by the manufacturers of IFN-alpha2a and -alpha2b (PegIFNalfa2a [Hoffman-La Roche, Basel, Switzerland] and PegIFNalfa2b [Schering Plough Corp, Kenilworth, NJ]) left clinicians facing the dilemma of which drug was best for the treatment of their patients (Clin Pharmacol Ther 2000;68:556-567; Bioconjug Chem 2001;12:195-202).