Background:The standard therapeutic procedure of first choice in the treatment of chronic infections with the hepatitis C virus (HCV)is the use of a double combination of interferon-alpha (IFN)and ribavirin (RBV).In the past the drug of choice was monotherapy with interferon-alpha.There is thus the possibility to compare the effectiveness of the double combination in different groups of patients who differ as to their response to interferon monotherapy. Objectives:1.To assess the effectiveness of double combination therapy in relation to the effect of previous monotherapy with IFN alpha.2.To assess the effectiveness of the double combination therapy as the proce- dure of first choice. Patients and methods:The group of patients comprised a total of 45 patients with chronic HCV infection with a hepatic lesion of chronic hepatitis of different activity verified by biopsy.Group A:30 patients where the double combination was used only for repeated treatment after failure of IFN monotherapy.Group B:15 patients where double combination was indicated as the procedure of first choice.In the defined groups the effectiveness of the double combination was tested.To evaluate the relationship of these categories the binomial distribution was used and the differences between categories were tested by the standard binomial test. Results:The following rate of success of double combination therapy was achieved:group A:47%,group B: 40%(NS).A statistically significant difference was achieved on comparison with partial and complete respon- se to IFN monotherapy vs.the group resistant to monotherapy (73%vs.10%,p <0.001). Conclusion:It was possible to prove that there exists a very close relationship between the favourable respon- se to IFN monotherapy and the effect of double combination therapy.Patients resistant to IFN monotherapy are successfully cured with the double combination only in 10%of the cases.Conversely patients with a favourable response to IFN (partial and complete response)can be cured in 73%.The total effectiveness in the two groups is comparable.

        Key words: chronc HCV infection – interferon--alpha –ribavirin