1 Guidance

This is an extension of the guidance given in Hepatitis C - pegylated interferons, ribavirin and alfa interferon (NICE technology appraisal guidance 75).

This guidance and TA75 have been partially updated by 'Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C' (NICE technology appraisal guidance 200) and 'Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people' (NICE technology appraisal guidance 300).

For details, see 'About this guidance'.

1.1 Combination therapy, comprising peginterferon alfa-2a and ribavirin or peginterferon alfa-2b and ribavirin, is recommended, within the licensed indications of these drugs, for the treatment of mild chronic hepatitis C.

1.2 Monotherapy with peginterferon alfa-2a or peginterferon alfa-2b is recommended, within the licensed indications of these drugs, for the treatment of mild chronic hepatitis C for people who are unable to tolerate ribavirin, or for whom ribavirin is contraindicated.

1.3 The decision on whether a person with mild chronic hepatitis C should be treated immediately or should wait until the disease has reached a moderate stage ('watchful waiting') should be made by the person after fully informed consultation with the responsible clinician. The decision to treat need not depend on a liver biopsy to determine the stage of the disease if treatment is initiated immediately. However, a biopsy may be recommended by the clinician for other reasons or if a strategy of watchful waiting is chosen.

1.4 This recommendation has been updated and replaced by NICE technology appraisal guidance 200 ( 'Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C' ).

1.5 This recommendation has been updated and replaced by NICE technology appraisal guidance 200 ( 'Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C' ).

1.6 This recommendation has been partially updated and replaced by NICE technology appraisal guidance 300 ( 'Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people' ). There is insufficient evidence to recommend combination therapy or monotherapy with peginterferon alfa for people who have had a liver transplant.