The interaction between macrophages and hepatocytes plays a critical role in interferon responsiveness; however, the addition of a protease inhibitor (PI) at least partially overcomes the interferon nonresponse phenotype, making the predictive ability of interferon-stimulated gene (ISG) staining less clinically useful. This according to a study of 56 patients with chronic HCV. Researchers found:

• 73% of patients achieved sustained virological response, 4% relapsed, 18% were nonresponders (NRs), and 5% were lost to follow-up.

• Median M-MxA staining was stronger and H-MxA staining was weaker in patients who achieved SVR.

• MxA staining correlated with IL28B genotype and with the HCV RNA decline during lead-in phase.

• However, unlike with dual therapy, the negative predictive value of absent or weak M-MxA staining was poor (42%), while the positive predictive value improved (93%).

• Although by multivariable logistic regression M-MxA staining was significantly associated with SVR, the predictive ability was inadequate to withhold therapy.

Citation: Duarte-Rojo A, Fischer SE, Adeyi O, et al. Protease inhibitors partially overcome the interferon nonresponse phenotype in patients with chronic hepatitis C. [Published online ahead of print December 29, 2015]. J Viral Hepat. doi: 10.1111/jvh.12494.