title: Long-term follow-up of previous hepatitis C virus positive nonresponders to interferon monotherapy successfully retreated with combination therapy: are they really cured?
abstract: OBJECTIVE
  To evaluate whether in chronic hepatitis C-positive patients who failed to respond to interferon (IFN) monotherapy a sustained response obtained with retreatment using the combination therapy of IFN + ribavirin can be safely considered to reflect eradication of the infection.
  
  
  METHODS
  Prospective follow-up of a cohort of 97 patients who responded to retreatment with different regimens of IFN + ribavirin after failing to respond to a first IFN monotherapy course. The patients were followed throughout 7 yr of follow-up with determinations of HCV viremia every 6 months.
  
  
  RESULTS
  At the end of the follow-up, 11 patients (11.3%) showed a viremic reappearance. HCV late relapse rates were 0%, 13%, 20%, and 12% in patients retreated, respectively, with 3 MU IFN + ribavirin for 12 months (Group 1), 5 MU IFN + ribavirin for 12 months (Group 2), 3 MU IFN + ribavirin for 6 months (Group 3), and 5 MU IFN + ribavirin for 6 months (Group 4) (Group 2 vs Group 3, p= 0.005). The virologic relapses occurred within 2 yr from therapy withdrawal. Among patients with genotype 1 and 4, the long-term response was significantly higher in Group 2 than in Group 3 (15%vs 3%, p= 0.03). In patients with genotype 2 and 3, the long-term virological response was not affected by the different regimens.
  
  
  CONCLUSIONS
  Nonresponders to IFN monotherapy who achieve a sustained virologic response after retreatment with IFN + ribavirin stand a discrete risk of HCV reactivation within 2 yr after therapy.
authors.affiliation: Dipartimento di Gastroenterologia, Ospedale Molinette, Torino, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Ciancio
authors.forename: Antonina
authors.initials: A
authors.lastname: Smedile
authors.forename: Chiara
authors.initials: C
authors.lastname: Giordanino
authors.forename: Cosimo
authors.initials: C
authors.lastname: Colletta
authors.forename: Guido
authors.initials: G
authors.lastname: Croce
authors.forename: Massimo
authors.initials: M
authors.lastname: Pozzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cariti
authors.forename: Antonio
authors.initials: A
authors.lastname: Macor
authors.forename: Alberto
authors.initials: A
authors.lastname: Biglino
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Napoli
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Tappero
authors.forename: Massimo
authors.initials: M
authors.lastname: Andreoni
authors.forename: Aldo
authors.initials: A
authors.lastname: Manca
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Prandi
authors.forename: Guido
authors.initials: G
authors.lastname: Calleri
authors.forename: Pier Giulio
authors.initials: PG
authors.lastname: Orsi
authors.forename: Giovannino
authors.initials: G
authors.lastname: Ciccone
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin