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Peginterferon alfa-2b + ribavirin is a combination antiviral regimen formerly used as the standard of care for the treatment of chronic hepatitis C virus (HCV) infection, particularly genotypes 1 and 4. The regimen consists of peginterferon alfa-2b, a pegylated form of recombinant interferon alfa-2b, and ribavirin, a synthetic nucleoside analog. Peginterferon alfa-2b acts by binding to type I interferon receptors, thereby activating the JAK-STAT signaling pathway and inducing the expression of various antiviral genes in host cells. Ribavirin is believed to exert its antiviral effects through multiple mechanisms, including the inhibition of the viral RNA-dependent RNA polymerase (NS5B), induction of lethal mutagenesis in the viral genome, and inhibition of the host enzyme inosine-5'-monophosphate dehydrogenase (IMPDH). While highly effective in its time, this combination has largely been superseded by direct-acting antiviral (DAA) therapies which offer higher cure rates and better tolerability.
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