Immunological modifications during treatment with thymosin alpha 1 plus antiviral therapy in chronic hepatitis C

The current standard therapy for the treatment of chronic hepatitis C virus (HCV) is the combination of peginterferon and ribavirin, although many patients fail to clear the virus and their retreatment options are still unsatisfactory. Thymosin alpha 1 (T alpha 1) is an immunomodulating agent that has been proposed as complementary therapy for chronic HCV, especially in the setting of difficult-to-treat patients. The aim of this study was to evaluate, in patients nonresponsive to previous Peg-based therapy, the effect of standard antiviral therapy with or without T alpha 1 on peripheral lymphocyte subsets. Twenty-four patients, 12 receiving T alpha 1 and 12 standard therapy, were enrolled. Peripheral sub-populations were analyzed by flow cytometry. Although the addition of T alpha 1 did not seem to significantly modify the T-lymphocyte subpopulations, as comparable behaviors were observed in the CD4 and CD8 longitudinal evaluation, T alpha 1 produced an earlier increase of natural killer cells. An accurate selection of HCV patients who can benefit from immunomodulation is needed.