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chapter 36 Antiviral Interferons 243
prescribing or recommending them. For HCV
infection, the recommended dose of ribavirin
differs for each form as well.
• For HCV infection, the two pegylated interferons
have been shown to be equivalent, but their
dosing is not. Pegylated interferon-a 2a is given
in a fixed dose, while pegylated interferon-a
2b is dosed by weight. For HBV infection, only
pegylated interferon-a 2a has an FDA indication,
though pegylated interferon-a 2b has been
stud ied as well.
• Interferons commonly cause or exacerbate
depression, and are contraindicated in severe
depression and patients contemplating suicide.
There is generally no rush in the treatment
of chronic HCV infection, so ensure that your
patient’s depression is controlled (pharmacologically
if necessary) before starting therapy.
For HBV infection, other drugs are better
choices in depressed patients.
• Evolving pharmacotherapy for the treatment of
HBV and HCV infection has changed the roles
of the interferons for these diseases. For HBV,
nucleoside/nucleotide analogs are preferred by
many clinicians (and patients) due to their
much better adverse effect profile, but they are
taken indefinitely compared to a finite regimen
for interferon. For HCV, pegylated interferon
therapy is essential and needs to be given with
ribavirin.
What They’re Good For
Pegylated interferons are the backbone of pharmacotherapy
regimens for HCV infection. For chronic
HBV infection, pegylated interferons are a first-line