Drug Class Review: Pegylated Interferons for Chronic Hepatitis C Infection: Final Report [Internet]

Hepatitis C virus (HCV) is the most common chronic blood borne pathogen in the United States. Chronic HCV infection has a variable course but can cause cirrhosis, liver failure, and hepatocellular cancer after a number of years. Dual therapy with pegylated interferon and ribavirin is now recommended as the antiviral regimen of choice for chronic HCV infection in patients who meet criteria for treatment. However, current guidelines make no recommendation for one pegylated interferon over the other, and it is unclear if there are clinically significant differences between dual therapy with pegylated interferon-alfa 2a versus pegylated interferon-alfa 2b. There is also uncertainty about comparative effectiveness and safety of dual therapy with pegylated interferons in subgroups of patients with HCV (such as those co-infected with HIV infection, those with higher fibrosis stage or higher viral load, those infected with genotype 1, or those who have already failed interferon-based therapy) and in how differences in duration of therapy or dose affect estimates of benefits and harms. The purpose of this review is to compare the benefits and harms of different pharmacologic treatments for chronic hepatitis C infection.