Clearance of hepatitis B surface antigen in chronic carriers of hepatitis delta antibodies

Niro, Grazia; Gravinese, Eleonora; Martini, Elisabetta; Garrubba, Maria; Facciorusso, Domenico; Conoscitore, P.; Giorgio, G. Di; Rizzetto, M.; Andriulli, Angelo

doi:10.1034/j.1600-0676.2001.021004254.x

Cited by 32 publications

(22 citation statements)

References 17 publications

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“…In agreement with a previous report (17), at the two time-points evaluated in the present investigation viremia levels of the two viruses fluctuated widely, an observation that could be related to either intrinsic mechanisms of reciprocal HDV-HBV inhibition or to the variable progression of the underlying liver disease (21). Seroclearance of HBsAg in patients with HDV chronic infection represents the ultimate step in the process of HDV clearance (22). Indeed, as long as the HBsAg is produced, HDV can thrive and sustain replication and liver disease.…”

Section: Discussionsupporting

confidence: 80%

Outcome of chronic delta hepatitis in Italy: A long-term cohort study

Niro

Smedile

Ippolito

et al. 2010

Journal of Hepatology

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130

109

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Section: Discussionsupporting

confidence: 80%

Outcome of chronic delta hepatitis in Italy: A long-term cohort study

Niro

Smedile

Ippolito

et al. 2010

Journal of Hepatology

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130

109

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“…15 Consistent with the superior results achieved in therapy of chronic HBV and HCV diseases using pegylated rather than standard IFN, the results of our study would also support the use of PEG-IFN as a first-line therapy and the recommendation to initiate therapy as early as possible for those with chronic hepatitis D. In fact, the efficacy of standard IFN-␣ in the treatment of chronic delta hepatitis (CHD) remains controversial; the few controlled and the many small uncontrolled trials of the use of standard IFN as a treatment for CHD found that HDV synthesis was suppressed in a fraction of patients while on therapy, but treatment failed to induce sustained clearance of the virus post-therapy; transient and occasionally even permanent clearance of HDV can also occur spontaneously in untreated patients. 26 At variance with the delayed clearance of HBsAg after spontaneous or standard IFN-induced clearance of HDV RNA from serum, [21][22][23][24][25][26][27] in the present study none of the patients treated with PEG-IFN who achieved a sustained response cleared this antigen, possibly because of the relatively short posttreatment follow-up.…”

Section: Discussionmentioning

confidence: 51%

Pegylated interferon alpha-2b as monotherapy or in combination with ribavirin in chronic hepatitis delta

et al. 2006

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Therapy of chronic hepatitis delta with standard interferon therapy has met with limited efficacy. This study was designed to examine the efficacy and safety of peginterferon with or without ribavirin. Thirty-eight serum hepatitis B surface antigen-and HDV RNA-positive patients with alanine aminotransferase (ALT) more than 1.5 times the upper normal limit received peginterferon alpha-2b (1.5 g/kg) alone as monotherapy (n ‫؍‬ 16) or in combination with ribavirin (n ‫؍‬ 22), for 48 weeks. Thereafter, all the patients were maintained on peginterferon for 24 weeks and followed for 24 weeks off therapy. The primary end point studied was the virological and biochemical response at the end of follow-up. HDV RNA was determined by single or nested polymerase chain reaction assays. Twenty-seven patients (71%), 11 receiving monotherapy and 16 receiving the combination treatment, completed the follow-up. At the end of treatment, a virological response was observed in 3 of the patients treated with peginterferon (19%) and in 2 of the patients treated with combination therapy (9%), and a biochemical response was observed in 6 (37.5%) and 9 patients (41%), respectively. In nonresponders, ALT diminished from a mean of 174 ؎ 53 to 86 ؎ 41 IU/L. At the end of follow-up, serum HDV RNA was negative in 8 patients (21%), and a biochemical response was detected in 10 patients (26%). Treatment was discontinued in 25% of the patients, and dosing was modified in 58%. In conclusion, a prolonged course of peginterferon alpha-2b resulted in clearance of serum HDV RNA and ALT normalization in a fifth of patients with chronic hepatitis D, while ribavirin had no effect on the viral clearance rate. Overall tolerance of therapy was poor. (HEPATOLOGY 2006;44:713-720.)

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“…Nevertheless clinical manifestations of liver disorders range from an asymptomatic carrier state to fulminant hepatitis and cirrhosis [10]. Disease resolution can occur in the natural history of HDV infection, leading to HBsAg seroclearance [11], and an historical benign course has been described in the Greek island of Rhodes and in American Samoa. In general, patients with hepatitis delta have a progressive disease, evolving to a stable or decompensated cirrhosis.…”

Section: Pathogenesismentioning

confidence: 99%

Current Concept in the Pathophysiology of Hepatitis Delta Infection

Niro

Smedile

2011

Curr Infect Dis Rep

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Hepatitis delta virus (HDV) is a unique human virus, showing similarities with plant viroids. Although impressive knowledge on virus structure and replication has been achieved, several questions like HBV/HDV interaction and post translational modifications of HD antigens remain to be answered. Potential targets for therapeutic strategies are now emerging. To date, eight major genotypes of the HDV have been identified. The HDV-1 is the prevailing genotype in Europe, but migration phenomena may change this profile. Immune response is likely to play an important role in the pathogenesis of HDV-induced liver disease; few data are available on T cells response either during infection and therapy. HDV usually suppresses HBV replication; recent studies show as viral dominances may change over time. Delta infection leads to severe liver disease, with different patterns of progression to liver fibrosis and decompensation. Beside the association between HDV/HBV and HCC is demonstrated a risk specifically related to HDV remains controversial.

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Clearance of hepatitis B surface antigen in chronic carriers of hepatitis delta antibodies

Abstract: HBsAg clearance is increased over the years in HDV patients compared to ordinary HBsAg carriers, and is often associated with improvement of HDV disease without seroconversion to anti-HBs.

Cited by 32 publications

References 17 publications

Outcome of chronic delta hepatitis in Italy: A long-term cohort study

Outcome of chronic delta hepatitis in Italy: A long-term cohort study

Pegylated interferon alpha-2b as monotherapy or in combination with ribavirin in chronic hepatitis delta

Current Concept in the Pathophysiology of Hepatitis Delta Infection

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