Nonresponse to interferon monotherapy in HCV-related chronic hepatitis: results of retreatment and prognostic factors.

At present two of the most relevant problems of the therapy of HCV-related chronic active hepatitis are the retreatment of nonresponders to interferon-alpha (IFN-alpha) and the definition of a prognostic index of response. We treated 44 patients who previously were nonresponders to IFN-alpha alone with IFN-alpha plus ribavirin for 12 months. Among the tests performed, we included the serum level of soluble intercellular adhesion molecule-1 (sICAM-1) at the beginning of the trial and at 3 months thereafter. We obtained 56.81% end of treatment responses and 47.72% sustained responses. A decrease of at least 10% of the sICAM-1 serum level during the first 3 months of treatment strongly correlated to the results of therapy while the usual important prognostic factors (HCV genotype and viral load) did not show this relation.