Antiviral Treatment Strategy

Genotype 1

1. Peginterferon alfa 2a (Pegasys) 180 mcg SC once weekly (regardless of weight) OR
2. Peginterferon alfa 2b (PEG-Intron) 1.5 mcg/kg SC once weekly up to 150 mcg/week (see chart below) AND

PEG-IFN alfa 2b Dosing

WT (lbs)	Vial Size (µg/0.5mL)	PEG dose (mL)
<88	50	0.5
88-110	80	0.4
111-141	80	0.5
142-166	120	0.4
167-187	120	0.5
>187	150	0.5

3. Ribavirin (Rebetol, Copegus)

RIBAVIRIN DOSE

WT (lbs)	Total Daily Dosage	Dosing Schedule
≤165	1,000 mg QD	2 (200 mg) tablets PO morning 3 (200 mg) tablets PO evening
>165	1,200 mg QD	3 (200 mg) tablets PO BID

4. Duration of therapy
• If 4-week HCV RNA undetectable (RVR), 24 weeks may be sufficient
• If no RVR, but 12-week HCV RNA undetectable or decreased by >2 log ₁₀ (EVR), 48 weeks is sufficient
• If no RVR or EVR, extending duration to 72 weeks may be beneficial if HCV RNA undetectable at week 24 (if patient has advanced fibrosis and depending on tolerance of therapy)

Next: Genotype 2-3