The purpose of this study is to evaluate the safety and efficacy of nitazoxanide-peginterferon and nitazoxanide-peginterferon-ribavirin combination regimens compared to the standard of care (peginterferon-ribavirin) in treating chronic hepatitis C genotype 4. The study will also evaluate the effect of the studied treatment regimens on end of treatment virologic response, ALT normalization and safety parameters.

Inclusion Criteria:

• Age ≥18 years.
• Chronic hepatitis C infection (at least 6 months) evidenced by a positive enzyme immunoassay for anti-HCV-antibodies and a positive quantitative RT-PCR amplification of HCV RNA.
• Chronic inflammation on liver biopsy compatible with a diagnosis of chronic viral hepatitis.
• HCV genotype 4.

Exclusion Criteria:

• Patients who have previously failed to respond to ≥12 weeks of peginterferon-ribavirin combination therapy.
• Females who are either pregnant, breast-feeding or not using birth control and are sexually active.
• Males whose female partners are pregnant.
• Patients with other causes of liver disease (i.e., autoimmune hepatitis, decompensated liver disease).
• Patients co-infected with hepatitis A virus, hepatitis B virus or hepatitis D virus.
• Patients with a history of alcoholism or with an alcohol consumption of >40 grams per day.
• Patients with hemoglobinopathies (i.e., thalassemia major, sickle-cell anemia).
• Patients with any concomitant condition that, in the opinion of the investigator, would preclude evaluation of response or make it unlikely that the contemplated course of therapy and follow-up could be completed.
• History of hypersensitivity or intolerance to any of the excipients comprising the nitazoxanide tablets, peginterferon alfa-2a injectionable solution or ribavirin tablets.