Majority of the HCV infections are caused by HCV genotype 1 having high resistance to anti-HCV therapy among the Western population. Standard interferon (IFN) along with pegylated-interferon (pegIFN) α 2a or 2b combination with or without ribavirin is currently the approved therapy for HCV infection. Several factors are related with antiviral reaction and stratified according to factors related with virus, host, and on-treatment. The objectives of this review included exploration of phenomenon of interaction between HCV and IFN-α signalling pathway in patients receiving treatment with RBV and IFN-α as a combination therapy for chronic HCV infection (CHC). Another important objective of this review was to demonstrate mutations associated with ISDR region to develop understanding of the controversies and the correlations in resistance through chronic HCV-G1; in comparison to Japanese and other studies. Changes in SNPs occurring within IL28B were also evaluated along with the examination of relation between drugs and mutation. A literature review was performed commencing after literature search. Pertinent literature was searched through electronic databases PubMed, Science Direct, ProQuest, and MEDLINE during the period 2010 to 2014. Manual searching of the grey literature and various websites was conducted to obtain epidemiological data of HCV. The standard treatment for HCV infection is RBV and pegIFN combination therapy. However, SVR is induced in 50% of the HCV genotype 1 infection patients. The results of IL28B genotyping studies revealed that there appear to be differences between the distributions of the polymorphisms in different populations infected with HCV. NS5A mutations to be connected with decreased reaction to IFN treatment among HCV patients with genotype 1. PegIFN can be administered along with RBV regardless of the genotype conferring polymorphism and mutations for the production of interferon. Conclusion: Standard treatment for HCV infection is combination therapy of RBV and pegIFN-α2a or -α2b. Mutations in the IL28B have to be considered prior to the administration of RBV and pegIFN therapy for treating HCV-G1 infection in patients. Clinical trials should evaluate the efficacy of RBV and pegIFN combination therapy for HCV-G1 infection.