O4 PROLONGED THERAPY OF HEPATITIS DELTA FOR 96 WEEKS WITH PEGYLATED-INTERFERON-α-2a PLUS TENOFOVIR OR PLACEBO DOES NOT PREVENT HDVRNA RELAPSE AFTER TREATMENT: THE HIDIT-2 STUDY

EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection

“…Even after 96 weeks of PegIFNa therapy, alone or in combination with TDF, 24-week post-therapy relapses occurred in 36-39% of the patients with on-treatment response. 165 The likelihood of the long-term response to PegIFNa can be estimated to some extent by HDV RNA and HBsAg kinetics at weeks 12 and 24. 164,[166][167][168][169] However, stopping PegIFNa prematurely at this stage is not recommended, if treatment is well tolerated, as the negative predictive values of these markers are not very strong, and late responses may occur in patients with early non-response.…”

Antiviral Therapy in Hepatitis B Virus-Associated Liver Cirrhosis

“…It has been shown that PEG-interferon is safe in patients with compensated cirrhosis and effectively reduces viral titers in a subset of patients [25,26]; however, viral relapse occurs frequently, even in those patients with undetectable HDV-RNA 6 months after the cessation of therapy [27]. Prolonging PEG-interferon therapy or adding tenofovir did not significantly impact on treatment responses [28]. Interestingly, however, recent reports suggest that treatment with tenofovir can positively influence disease progression in selected patients.…”

Chronic hepatitis D

“…Wedemeyer и соавт. [51] провели исследование HIDIT-2 по сравнительной оценке эффективности и переносимости комбинированной терапии ПЕГ-ИФН-α-2а и тенофовиром и монотерапии ПЕГ-ИФН-α-2а у пациентов с хронической дельта-ин-фекцией. Исследование HIDIT-1 ранее показало, что терапия ПЕГ-ИФН-α-2а в течение 1-1,5 года эф-фективна лишь у 25-30% пациентов, и ингибиторы HBV полимеразы не приводят к супрессии РНК HDV.…”

“…По мнению Mario Rizzetto, открывшего в 1977 г. вирус ВГD, «... данное исследование подтверждает то, что мы уже знаем...» -что рецидив репликации HDV наступает в большинстве случаев после пре-кращения терапии [51].…”