In patients with chronic hepatitis C and cirrhosis or bridging fibrosis, 180 microg of peginterferon alfa-2a administered once weekly is significantly more effective than 3 million units of standard interferon alfa-2a administered three times weekly.

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Multicenter randomized trials have shown that once-weekly pegylated interferon (peginterferon) alfa-2a is more efficacious than conventional interferon alfa-2a (IFN) in patients with chronic hepatitis C. We performed a meta-analysis of 1,013 previously untreated patients (from 3 randomized trials) with pretreatment and post-treatment liver biopsies to assess the differences between peginterferon alfa-2a and IFN in terms of their effects on liver histology. Reported values were standardized mean differences (SMD) between patients receiving peginterferon alfa-2a and those receiving IFN (post-treatment value minus baseline value for each group). We used a random-effects model to quantify the average effect of peginterferon alfa-2a on liver histology. Peginterferon alfa-2a significantly reduced fibrosis compared with IFN (SMD, ؊0.14; 95% CI: ؊0.27, ؊0.01; P ‫؍‬ .04). A reduction in fibrosis was observed among sustained virologic responders (SMD, ؊0.59; 95% CI: ؊0.89, ؊0.30; P < .0001) and patients with recurrent disease (SMD, ؊0.34; 95% CI: ؊0.54, ؊0.14; P ‫؍‬ .0007), whereas no significant reduction was observed among nonresponders (SMD, ؊0.

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