Hepatitis C - peginterferon alfa and ribavirin - NICE TAG TA200

This guidance should be read in conjunction with the following NICE guidance:

• NICE technology appraisal guidance 75 (TA75) 'Interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C' (which covers moderate to severe hepatitis C)

• NICE technology appraisal guidance 106 (TA106) 'Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C'.

This appraisal addresses extensions to the marketing authorisations for peginterferon alfa-2a and peginterferon alfa-2b. This guidance updates and replaces:

• section 1.2, bullet 3 only, of TA75

• section 1.4 of TA75 for adults who are eligible for shortened courses of combination therapy (as described in section 1.2 of the current guidance)

• section 1.7, bullet 1 only, of TA75

• sections 1.4 and 1.5 of TA106.

All other recommendations in TA75 and TA106 still stand.

1.1 Combination therapy with peginterferon alfa (2a or 2b) and ribavirin is recommended as a treatment option for adults with chronic hepatitis C:

• who have been treated previously with peginterferon alfa (2a or 2b) and ribavirin in combination, or with peginterferon alfa monotherapy, and whose condition either did not respond to treatment or responded initially to treatment but subsequently relapsed or

• who are co-infected with HIV.

1.2 Shortened courses of combination therapy with peginterferon alfa (2a or 2b) and ribavirin are recommended for the treatment of adults with chronic hepatitis C who:

• have a rapid virological response to treatment at week 4 that is identified by a highly sensitive test and

• are considered suitable for a shortened course of treatment.

1.3 When deciding on the duration of combination therapy, clinicians should take into account the licensed indication of the chosen drug (peginterferon alfa-2a or peginterferon alfa-2b), the genotype of the hepatitis C virus, the viral load at the start of treatment and the response to treatment (as indicated by the viral load).

http://www.nice.org.uk/guidance/TA200