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This combination therapy consists of pegylated interferon alfa-2a and ribavirin, which served as the standard of care for chronic hepatitis C virus (HCV) infection prior to the widespread adoption of all-oral direct-acting antiviral (DAA) regimens. Pegylated interferon alfa-2a is a conjugate of recombinant interferon alfa-2a with a 40 kDa branched polyethylene glycol chain, which enhances its pharmacokinetic profile by significantly extending its half-life. It works by binding to the interferon alpha/beta receptors, triggering a signaling cascade that induces an antiviral state in host cells. Ribavirin is a synthetic guanosine analog that exerts broad-spectrum antiviral effects through multiple mechanisms, including the inhibition of inosine-5'-monophosphate dehydrogenase (IMPDH), interference with viral RNA polymerase, and the induction of lethal mutagenesis in the viral genome. In the context of the PROGRESSIVE-C study conducted by Parc de Salut Mar, this regimen was evaluated for its efficacy and safety in patients with HCV-related cirrhosis, specifically focusing on its impact on portal hypertension and gastroesophageal varices.
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