Should We Treat Chronic Hepatitis C in HIV with Peginterferon Alpha 2a or 2b?

Since 2001, the recommended therapy for patients withchronic hepatitis C virus (HCV) infection is a combinationof pegylated interferon alpha (PEG-IFNα) plus ribavirin.The two commercially available preparations of PEG-IFNα(2a and 2b) differ in pegylation sites, molecular weight,and structure, resulting in significant differences in pharmacokineticand pharmacodynamic properties. The registrationtrials of both PEG-IFNα for the treatment of chronichepatitis C conducted almost 10 years ago yielded sustainedvirologic response (SVR) rates of 54% for PEG-IFNα2b (Manns, et al. Lancet. 2001;358:958-65) and 56-63%for PEG-IFNα 2a respectively (Fried, et al. N Engl J Med.2002;347:975-82; Hadziyannis, et al. Ann Intern Med.2004;140:346-55). Accordingly, and in the absence of ahead-to-head comparative trial, both PEG-IFNs were consideredas equipotent.