Management of patients with HCV infection poorly tolerant to recombinant interferon alpha

To evaluate leukocyte interferon-alpha tolerability and efficacy in the retreatment of patients poorly tolerant to recombinant interferon-alpha.

Patients with chronic hepatitis C, poorly tolerant to a previous interferon-alpha treatment (118 patients; 73 "relapsers": Group I; 45 "non-responders": Group II) were retreated with 6 MU tiw of leukocyte interferon-alpha for 6 months and then followed-up for 12-34 months. Only patients with complete regression of any previous interferon-related adverse event were included.

Three patients dropped out due to recurrence of a severe depressive syndrome. In 86/115 patients (75%) no significant lifestyle changes versus baseline were observed during retreatment, while 29 subjects experienced a moderately negative interference on their living habits. The different influence on the patients' quality of life of leukocyte interferon in comparison with the previous treatment was significant (P < 0.001). In 98 patients the interferon-related adverse events significantly decreased. After 12 months of follow-up, a sustained biochemical response was observed in 40 patients (Group I:31; Group II:9), and a persistent virological response in 28 (Group I:23; Group II:5).

The good compliance with leukocyte interferon administration shown by poorly tolerant patients, non-responders/relapsers to recombinant interferon, permitted a retreatment with full doses, so increasing the chance to obtain a larger number of sustained responses.