46 LONG-TERM FOLLOW-UP AFTER PEG-IFNa2a-BASED THERAPY OF CHRONIC HEPATITIS DELTA

Heidrich, B.; Yurdaydın, Cihan; Kabaçam, Gökhan; Zachou, Kalliopi; Bremer, Birgit; Dalekos, George Ν.; Erhardt, A.; Çakalǒglu, Yılmaz; Yalçın, Kendal; Gürel, Selım; Zeuzem, Stefan; Bock, T.; İdilman, Ramazan; Manns, M.P.; Wedemeyer, Heiner

doi:10.1016/s0168-8278(13)60048-3

Cited by 6 publications

(7 citation statements)

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“…Of the 17 patients who had a virologic response at 6 months post‐treatment and were considered sustained virologic responders, nine patients had a virologic relapse on long‐term follow‐up lasting up to 5 years , which was documented both in the local laboratory and the central laboratory where HDV RNA determinations in the original study were performed. These nine patients were compared with the eight patients who continued to have a virologic response.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 17 patients who had a virologic response at 6 months post-treatment and were considered sustained virologic responders, nine patients had a virologic relapse on long-term follow-up lasting up to 5 years (11), which was documented both in the local labora-…”

Section: Effect Of Treatment On Hepatitis Delta and Hepatitis B Protementioning

confidence: 99%

“…A recent study suggests that HDAg in liver tissue may have potential prognostic implications after liver transplantation (8) and availability of quantitative HBsAg determinations may further our understanding in viral pathogenesis as studied for chronic hepatitis B (CHB) (9). Currently, the only established evidence-based treatment of CDH is with conventional or pegylated interferons, effective in roughly a quarter of patients, although optimal duration, standardization of HDV RNA measurement and reliability of post-treatment viral response are issues which still need to be addressed in future studies (10,11). In this study, variables associated with HDAg, HBsAg and HBcAg staining in the liver were assessed in CDH.…”

Section: Introductionmentioning

confidence: 99%

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Role of immunohistochemistry for hepatitis D and hepatitis B virus in hepatitis delta

Kabaçam

Wedemeyer

Savaş

et al. 2013

Liver International

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These data suggest an association of liver injury with HDAg expression in CDH whereas the negative correlation between HBcAg expression and liver injury and the overall nuclear localization of HBcAg suggest that HBcAg does not contribute to liver injury in CDH. HDV cases with high level of HBV replication, high serum HBsAg levels, HBeAg positivity, that are probably in the earlier stages of disease (low gamma-glutamyl transferase), had a more intense HBsAg staining profile. Overall, the data enforce the importance of HDAg and HBsAg in different phases of CDH infection.

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Section: Resultsmentioning

confidence: 99%

Section: Effect Of Treatment On Hepatitis Delta and Hepatitis B Protementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of immunohistochemistry for hepatitis D and hepatitis B virus in hepatitis delta

Kabaçam

Wedemeyer

Savaş

et al. 2013

Liver International

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“…Although late relapses have been documented, in a study performed by Hedrich and colleagues in patients who were HDV RNA negative 6 months after pegylated interferon treatment, pegylated interferon alfa 2a treatment was given for 48 weeks with or without adefovir and resulted in 28 % of the patients having undetectable HDV RNA 6 months post-treatment [ 435 ]. In long-term follow-up of patients for approximately 4 years, a significant number of patients were tested HDV RNA positive at least once during further follow-up, and it was also concluded by the investigators to closely monitor patients post-Peg interferon therapy, even those who are HDV RNA negative 6 months after therapy with interferon alfa 2a therapy.…”

Section: Guidelinesmentioning

confidence: 99%

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update

et al. 2015

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Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts’ personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

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“…24 The rate of cure is even more dismal as hepatitis D viraemia might relapse post-therapy; in the HIDIT-1 study, 8 of 16 patients who were HDV RNA negative 6 months after PEG-IFN therapy became HDV-RNA positive at least once during a follow-up of ~4 years. 25 The advent of potent antivirals against HBV infection suggested that the inhibition of HBV might also control HDV, but, unfortunately, lamivudine, adefovir and entecavir 24,26,28 have no effect. One potential explanation for this lack of effect is that HDV only requires the HBsAg coat from HBV to penetrate hepatocytes.…”

Section: The Therapeutic Perspectivementioning

confidence: 99%

Chronic hepatitis D at a standstill: where do we go from here?

Ciancio

Rizzetto

2013

Nat Rev Gastroenterol Hepatol

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Immigration is fuelling a new reservoir of hepatitis D virus (HDV) in Europe, and hepatitis D still represents an important medical problem in the USA. The disease continues to be a major medical scourge in the developing world, in particular in countries such as Pakistan, Mongolia and Mauritania. New therapeutic strategies are being developed to disrupt interactions between HDV and its viral partner HBV, or with the host. Blocking or modifying the hepatitis B surface antigen (HBsAg) might interfere with the uptake or release of the hepatitis D virion; interference with host-mediated post-translational changes of proteins that are crucial to the HDV life cycle, such as prenylation, is another potential therapeutic option. At present, however, the only realistic option is to optimize IFN-α therapy. As eradication of HBsAg is the ultimate end point of therapy, long-term interferon administration might be required, raising an issue of tolerance in patients. Treatment with IFN-λ is a potential alternative approach to IFN-α; treatment of hepatitis C with this cytokine seems to cause fewer adverse effects than IFN-α and, therefore, might be more suitable for long-term treatment of HDV.

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46 LONG-TERM FOLLOW-UP AFTER PEG-IFNa2a-BASED THERAPY OF CHRONIC HEPATITIS DELTA

Cited by 6 publications

References 0 publications

Role of immunohistochemistry for hepatitis D and hepatitis B virus in hepatitis delta

Role of immunohistochemistry for hepatitis D and hepatitis B virus in hepatitis delta

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update

Chronic hepatitis D at a standstill: where do we go from here?

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