Chronic hepatitis delta: A state-of-the-art review and new therapies

Gilman, Christy; Heller, Theo; Koh, Christopher

doi:10.3748/wjg.v25.i32.4580

Cited by 36 publications

(26 citation statements)

References 150 publications

(161 reference statements)

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“…The male predominance found in this work is the same as that found by Stockdale et al in 2017 [25] in London and Luma et al in Cameroon in 2017 [23]. The risk factors found in delta virus infection are mainly male homosexuality, intravenous drug use, human immunodeficiency virus (HIV), hepatitis C virus infection and sexual intercourse with multiple partners [26,27]. The VR was 67.67% in this work.…”

Section: Discussionsupporting

confidence: 87%

“…It has been shown that in addition to the effect on virological response, it also has a significant effect on transaminase normalization, fibrosis regression and even survival [26]. The use of a combination of interferon and analogues in the treatment of HDV has not demonstrated its effect [26,27]. The persistence of Delta viral replication is a predictive factor of mortality [27].…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore imperative to treat patients with the available molecules by strictly monitoring adverse reactions. Normalization of transaminases under interferon is observed in 40 to 70% of patients under treatment with a risk of escape in nearly 97% of cases [26,27].…”

Section: Discussionmentioning

confidence: 99%

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Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country

Bagnaka

Nga²,

Kenfack³

et al. 2020

OJGH

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Research Article OJGH (2020) 3:32 Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country The prevalence of Hepatitis Delta Virus (HDV) infection in Cameroon is 11.01%. Pegylated interferon alpha 2a (PEG-IFN α 2a) is the standard treatment worldwide. This study aimed to describe the virological response to this drug in cameroonians. Methods: We carried out a cross-sectional study from 1 January 2012 to 31 December 2018. It took place in eleven (11) health facilities of Yaoundé and Douala. Patients with HDV infection and treated with PEG INF α 2a for at least 48 weeks were included. The primary endpoint was Virologic Response (VR) and secondary endpoints were Rapid Virologic Response (RVR) and Late Virologic Response (LVR). Results: We included 133 patients. The mean age was 36.33 ± 10.9 years. The male sex accounted for 65.41% of cases. The VR was 67.67%. Leukopenia, fever, headache, asthenia and abdominal pain were the most common adverse events in 88.72%, 68.42%, 53.38%, 45.11% and 35.34% of cases respectively. Factors associated with VR were the presence of diabetes (aOR= 4.32; CI95% [1.22-15.30], p= 0.023), fever (aOR= 5.16, CI95% [1.48-18.04], p=0.01) and ALT levels greater than 40 IU/l (aOR= 3.69, IC95% [1.15-11.18], p= 0.028). Conclusion: VR is high in cameroonians. The presence of diabetes and elevated transaminases are factors associated with this virologic response. We recommend the use of interferon treatment for patients with HDV infection in Cameroon with very strict monitoring of side effects.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country

Bagnaka

Nga²,

Kenfack³

et al. 2020

OJGH

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“…The risk of HDV infection is high in injection drug users, patients with multiple sexual partners, men who have sex with men, individuals infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) and people from endemic areas . Soon after the discovery of HDV, injection drug users sharing needles were recognized as the major victims of this infection, with reported anti‐HDV rates in HBsAg‐positive patients in the 1980s ranging from 17% in Southern Europe to more than 90% in South Eastern Asia.…”

Section: High Risk Populationsmentioning

confidence: 99%

New epidemiology of hepatitis delta

Vlachogiannakos

Papatheodoridis

2020

Liver International

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Hepatitis D virus (HDV) is a defective pathogen that needs hepatitis B virus (HBV) for infection. Co‐infection of HBsAg‐positive individuals with HDV is commonly associated with a more rapid progression to cirrhosis, a higher incidence of hepatocellular carcinoma (HCC) and increased mortality. Initial studies have shown that about 5% of chronic HBV carriers worldwide (15‐20 millions) were also infected with HDV. However, recent studies suggest that the prevalence of HDV is at least two‐ to three‐fold higher than previous estimations. Improved diagnostic techniques have shown that HDV infection remains endemic in certain areas of the world. Injection drug users, individuals with high‐risk sexual behaviour and patients co‐infected with human immunodeficiency virus (HIV) represent the major reservoir of the disease in the Western world. Although the burden of HDV infection significantly decreased in Europe in the nineties, there has been no further decrease in the last decade, probably because of migration from HDV endemic countries. Until new and more effective therapies are available, public health measures should be reinforced by increasing prophylactic HBV vaccination programs, preventing transmission of the virus among parenteral drug users and implementing universal HDV screening of all HBV‐infected individuals.

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“…No US Food and Drug Administration-approved treatment of HDV exists, and the only somewhat effective treatment is pegylated interferon, with only 25% to 30% of patients able to control the virus with weekly injections administered for at least 1 year (17,18). When coinfection is poorly controlled, patients are 3 times as likely to develop cirrhosis and liver cancer, compared with HBV infection alone.…”

Section: Introductionmentioning

confidence: 99%