This guidance has been partially updated by peginterferon alfa and ribavirin for the treatment of chronic hepatitis C and peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people.

For details, see about this guidance.

Peginterferon alfa and ribavirin are recommended as possible treatments for people with mild chronic hepatitis C if they are suitable for the person and are used in these ways.

A person who has mild chronic hepatitis C is offered treatment with a combination of peginterferon alfa and ribivarin.

People who are not able to take ribivarin are offered treatment with peginterferon alfa on its own.

The person's doctor should discuss with them whether to start treatment immediately, or to wait and only take the drugs if the disease gets worse. This is called ‘watchful waiting'. If the person decides to wait the doctor might suggest taking a small sample from the liver (a ‘biopsy') to check how bad the disease is. A biopsy might also be needed for other reasons.

How long the treatment lasts will depend on which drug is used, what dose the person takes, what type of virus the person has, how much of the virus is in their body, and how well the treatment is working.

If the person has had treatment with peginterferon alfa (with or without ribivarin) but it has not worked after 12 weeks, they should not be offered a second course of treatment.

NICE has not been able to make a recommendation about whether peginterferon alfa is suitable for people who are younger than 18 years old, or who have had a liver transplant, because there is not enough evidence.

This is an extension of the guidance given in hepatitis C - pegylated interferons, ribavirin and alfa interferon.