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.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.