Origin, HDV genotype and persistent viremia determine outcome and treatment response in patients with chronic hepatitis delta

Roulot, Dominique; Brichler, Ségolène; Layese, Richard; Benabdesselam, Z.; Zoulim, Fabien; Thibault, Vincent; Scholtès, Caroline; Roche, Bruno; Castelnau, Corinne; Poynard, Thierry; Chazouillères, Olivier; Ganne, Nathalie; Fontaine, Hélène; Gournay, Jérôme; Guyader, Dominique; Gal, Frédéric Le; Nahon, Pierre; Roudot‐Thoraval, Françoise; Gordien, Emmanuel; Grangé, Jean‐Didier; Landman, Roland; Hézode, Christophe; Riachi, Ghassan; Lascoux-Combe, Caroline; Loustaud‐Ratti, Véronique; Rosa, Isabelle; Maury, Philippe; Nguyen‐Khac, Eric; Causse, Xavier; Naveau, Sylvie; Habersetzer, François; Métivier, Sophie; Labadie, H; Sellier, Pierre; Bottéro, J.; Lédinghen, Victor de; Alric, Laurent; Calès, Paul; Goujard, Cécile; Cadranel, Jean–François; Salmon, Dominique; Hillaire, Sophie

doi:10.1016/j.jhep.2020.06.038

Cited by 87 publications

(147 citation statements)

References 45 publications

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“…123 This can be explained by the effective control of hepatitis B afforded by antivirals in contrast with the poor efficacy of therapeutic options available for HDV, which cannot prevent progression to end-stage cirrhosis in most cases. 124 The clinical features of CHD in immigrants have been studied in 2 large series, one of 1,112 immigrants in France, 125 and the other of 337 immigrants in Sweden. 126 In the French series the mean age of patients was 36.5 years; 77% had active HDV infection, based on increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.…”

Section: Key Pointmentioning

confidence: 99%

The changing context of hepatitis D

Rizzetto

Salehiniya

Negro

2021

Journal of Hepatology

102

117

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The global epidemiology of hepatitis D is changing with the widespread implementation of vaccination against hepatitis B. In high-income countries that achieved optimal control of HBV, the epidemiology of hepatitis D is dual, consisting of an ageing cohort of domestic patients with advanced liver fibrosis who represent the end stage of the natural history of HDV, and of a younger generation of immigrants from endemic countries who account for the majority of new infections. As observed in Europe in the 1980s, the distinctive clinical characteristic of chronic hepatitis D in endemic countries is the accelerated progression to cirrhosis and hepatocellular carcinoma. Despite some recent progress, the therapeutic management of HDV remains unsatisfactory, as most patients are not cured of HDV with currently available medicines. This review article describes the current epidemiology and clinical features of chronic hepatitis D, based on the literature published in the last 10 years.

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Section: Key Pointmentioning

confidence: 99%

The changing context of hepatitis D

Rizzetto

Salehiniya

Negro

2021

Journal of Hepatology

102

117

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“…A recent nationwide retrospective French study investigated 375 HDV patients with compensated cirrhosis; positive HDV-RNA at the most recent evaluation, an older age, being overweight, total serum bilirubin >17 mmol/L, and low platelet count were all identified as independent factors associated with liver decompensation. In a further analysis, the presence of HDV RNA at the most recent evaluation (HR = 2.14, p = 0.01), an older age (HR = 1.08, p < 0.001), past alcohol intake (HR = 2.39, p = 0.010), prothrombin time < 80% (HR = 4.15, p < 0.001), platelet count <100,000/mm 3 (HR = 2.56, p = 0.016) and serum GGT >2-times the normal value (HR = 3.70, p = 0.002) were identified as independent factors associated with the development of HCC [ 77 ].…”

Section: From Hdv Infection To Liver Cirrhosis and Hcc Here Too Smentioning

confidence: 99%

“…In a study from Taiwan, 51 patients infected with HDV genotype 1 showed a lower remission rate (15.2% vs. 40.2%; p = 0.007) and a more adverse outcomes (cirrhosis, hepatocellular carcinoma, or mortality) (52.2% vs. 25.0%; p = 0.005) than 74 patients with HDV genotype 2 [ 79 ]. Recent data from Roulot et al indicate that European patients with HDV genotype 1 and African patients with HDV genotype 5 are at a high risk of developing cirrhosis [ 77 ]. In a small British cohort considering 21 African and 9 European patients with HBV/HDV coinfection, those born in Africa were all infected with HDV-5 and showed a better prognosis than those born in Europe, which were mostly infected with HDV-1 [ 80 ].…”

Section: From Hdv Infection To Liver Cirrhosis and Hcc Here Too Smentioning

confidence: 99%

HBV/HDV Co-Infection: Epidemiological and Clinical Changes, Recent Knowledge and Future Challenges

Sagnelli

Russo

et al. 2021

Life

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Several investigations have been published on Hepatitis Delta Virus (HDV) infection in recent years, from which we have drawn the salient data to provide readers with useful information to improve their knowledge on the subject. HDV genotypes 5–8 have been recently imported to Western countries from central Africa, whose clinical relevance deserves further investigation. Ongoing HDV replication has been identified as an independent predictor of progression to cirrhosis and HCC for patients with HDV chronic hepatitis (HDV-CH). Long-term treatments of HDV-CH with standard or pegylated interferon alfa (peg-IFN-α) have all been unsatisfactory, leading to a sustained virological response (SVR) only in 20–30% of patients treated, faced with a poor tolerability and frequent serious adverse reactions; the addition of HBV nucleo(s)tide analogues to peg-IFN- α did not improve the rate of SVR. The improved knowledge of the HDV life cycle has allowed the development of direct acting agents towards key-points of the HDV life cycle, namely bulevirtide, lonafarnib and nucleic acid polymers. Preliminary data have shown that these drugs are more effective than interferon-based therapies, but adverse reactions are also common, which however seem toned down in combination therapy with other antivirals.

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“…10 Moreover, the distinct course of liver disease and response to interferon treatment of HDV genotype 5 infectionwhich is highly prevalent in sub-Saharan Africabecame evident in 2 reports recently published in the Journal of Hepatology. 11,12 Finally, new drugs against HDV are currently being explored in phase II and III clinical trials which led to a controversial discussion on treatment endpoints. 13,14 On May 28 2020, the EMA's Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a conditional marketing authorization for bulevirtide, the most advanced new compound to treat hepatitis D. Thus, new drugs for this most severe form of viral hepatitis are no longer on the horizon, the door is almost open for many patients.…”

mentioning

confidence: 99%

The burden of hepatitis D – defogging the epidemiological horizon

Wedemeyer

2020

Journal of Hepatology

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Origin, HDV genotype and persistent viremia determine outcome and treatment response in patients with chronic hepatitis delta

Cited by 87 publications

References 45 publications

The changing context of hepatitis D

The changing context of hepatitis D

HBV/HDV Co-Infection: Epidemiological and Clinical Changes, Recent Knowledge and Future Challenges

The burden of hepatitis D – defogging the epidemiological horizon

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