Peginterferon plus Adefovir versus Either Drug Alone for Hepatitis Delta

Abstract

Treatment with peginterferon alfa-2a for 48 weeks, with or without adefovir, resulted in sustained HDV RNA clearance in about one quarter of patients with HDV infection. (Current Controlled Trials number, ISRCTN83587695.).

PEG-IFN for the treatment of hepatitis D

“…Treatment with this type of IFN induced rates of sustained virological responses that varied from 17% to 43%4-6 However, these studies also included only a small number of patients and are difficult to compare because of the clinical heterogeneity of the patients; the highest rates of sustained virological response were reported in a series of 14 patients, most of whom did not have cirrhosis (a common complication in patients with HDV). 5 The paper by Wedemeyer and coworkers 7 provides information on what can be achieved with PEG-IFN-2a in patients infected with HBV and HDV. Wedemeyer et al compared the efficacy of PEG-IFN-2a alone versus its combination with adefovir and adefovir monotherapy.…”

Molecular and clinical aspects of hepatitis D virus infections

“…In 2006 three small studies could show effectiveness for this type of treatment [41][42][43] , but nevertheless SVR rates remained low (17% to 43%) overall. In a multicentre randomised landmark trial published in 2011, Wedemeyer et al [44] achieved 28% SVR. These differences in SVR rates compared to prior smaller trials might be due to baseline clinical, demographical and virological characteristics [30] .…”

“…The latter could possibly benefit from a prolonged treatment, because HDV decrease might occur late, even after the end of treatment [44] . Clear predictors of response to IFN have not been identified, but viral load determination at 6 mo of treatment might be helpful [41,43] .…”

Delta Hepatitis

“…In addition, clevudine could cause severe myopathy by depletion of mitochondrial DNA as side effect [77]. A multicenter randomized study (HIDIT I) compared the efficacy of peg-IFN alpha-2a plus adefovir versus peg-IFN alpha-2a plus placebo versus adefovir in chronic HDV infection [78]. 72-week results of this study showed that peg-IFN alpha-2a had a significant antiviral effect for HDV in more than 40% of patients, HDV-RNA relapse had occurred in only 1 patient, and 8 additional patients receiving peg-IFN had become negative after stopping therapy.…”

“…72-week results of this study showed that peg-IFN alpha-2a had a significant antiviral effect for HDV in more than 40% of patients, HDV-RNA relapse had occurred in only 1 patient, and 8 additional patients receiving peg-IFN had become negative after stopping therapy. Adefovir had not affected HDV replication but combination therapy of peg-IFN and adefovir had some advantages in terms of reduction of HBsAg levels [78]. An international study group had found positive correlation between the HBsAg levels and HDV viremia in chronic HDV infection [79].…”