A pilot study of 2 years of interferon treatment in patients with chronic delta hepatitis

Abstract

High dose interferon treatment for 1 year is the only established treatment for chronic hepatitis D, but it is associated with a high relapse rate after treatment discontinuation. In this study, patients were treated with 10 MU interferon alpha 2b, thrice weekly for 2 years. Twenty-three patients were recruited and 15 completed the 2-year treatment and 6 months follow-up periods. Treatment response was assessed biochemically [normal alanine aminotransferase (ALT)], virologically (undetectable hepatitis D virus RNA) and histologically (at least 2 point decrease in the Knodell score) at the end of treatment (EOT) and at the end of follow-up. Out of 15 patients who finished the 2-year treatment period, seven patients (47%) had a biochemical response but only two (13%) had a normal ALT after follow-up. ALT decreased from the baseline value of 143.1 +/- 121.7 (mean +/- SD) to 39.7 +/- 20.6 (P < 0.01) at EOT. Virological response was observed in six patients at EOT and in two patients at follow-up. Two patients lost hepatitis B surface antigen. Of the 12 patients with paired liver biopsies, a histological improvement was observed in eight patients. Interferon treatment leads to a complete or partial response in a substantial number of patients but 2 years of treatment does not appear to increase sustained response rates over 1 year treatment.

Treatment of Chronic Delta Hepatitis

“…These authors determined whether long-term therapy is more efficacious than 1-year therapy. Their results showed that both long-term and 1-year therapy had the same outcomes; this finding is similar to that of another Turkish study (1). Therefore, if there is no virologic response, then therapy should be discontinued after a year; this will help avoid causing unnecessary inconvenience to patients and reduce the costs incurred by health agencies.…”

Treatment of Chronic Delta Hepatitis: A Nine-Year Retrospective Analysis

“…Yurdaydin et al also compared patients receiving 1-year and 2-year treatments in Turkey and reported that 2 years of treatment does not appear to increase sustained response rates in comparison with 1 year of treatment (9). However, Gunsar et al reported that 2-year treatment is better than 1-year treatment (10).…”

“…We investigated 46 CDH patients, a large group for CDH, and observed that there is not much difference between 1-year and 2-year treatments in terms of virological, histological, and biochemical responses. Long-term PEG-IFN therapy might be more efficacious (9,11,12). Available trials indicate that high doses of interferon and a long duration of therapy were associated with a better biochemical response and improvement in liver histology (11).…”

Molecular and clinical aspects of hepatitis D virus infections

“…This was attended by improvement of liver histology (initially cirrhosis, after 10 years no abnormalities) [38] . Interestingly Yurdaydin et al [39] could not find a benefit for IFN treatment over 2 years instead of 1 year. However long-term data (12 years) showed a benefit of high-dose IFN α therapy (9 million units three times per week) with even regression of advanced hepatic fibrosis [40] .…”