Pegylated Interferon α Therapy in Chronic Delta Hepatitis: A One-Center Experience

Abstract

Background:The only established therapy for chronic viral delta hepatitis, the most severe form of viral hepatitis is treatment with pegylated-interferon α (Peg IFN α).Objectives:In this study, we aimed to determine the efficacy of pegylated-interferon α 2a (Peg-IFN α 2a) and 2b (Peg IFN α 2b) in the treatment of patients infected with chronic delta hepatitis virus.Patients and Methods:The sample size was based on available patients potentially to be recruited. Data of 63 patients receiving either Peg IFN alpha 2a or Peg IFN alpha 2b were retrospectively assessed in the present cohort study performed in Turkey. Of 56 patients completed the study, 41 received Peg IFN α 2a and 15 received Peg IFN α 2b for 12 months. Patients were evaluated for biochemical and virological responses at the end of given treatment and six months after the treatment.Results:Stage of fibrosis was found high in both groups (85.4% vs. 86.7%), while cirrhosis was higher in the group of Peg IFN α 2b (53.3% vs. 34.1%). At the end of treatment, either hepatitis delta virus RNA (HDV RNA) alone or both HDV RNA and hepatitis b virus DNA (HBV DNA) had negative results in 32% of patients. Although HDV RNA negativity was sustained in 30.3% of patients, negativity of both HDV RNA and HBV DNA was decreased to 19.6% six months after completion of the treatment. HBV DNA became positive in one third of patients with response at six months after completion of the treatment (10.7% of all patients). HDV RNA negativity at month six was found as a predictor of positive response. No significant difference was found between Peg IFN α 2a and Peg IFN α 2b for virological response rate.Conclusions:Treatment with Peg IFN α achieved a sustained negativity of HDV RNA in about one third of patients. Duration of Peg IFN α therapy might be prolonged to at least 24 months or more to prevent the occurrence of Hepatitis B virus (HBV) relapse encountered six months after completion of the treatment.

Dynamics of in vivo hepatitis D virus infection

“…Our results moderately also agreed with the Heidrich et al results who observed that chronic HBV DNA viremia becomes undetectable in some patients after 48 weeks of treatment (Heidrich et al, 2014). A recent study also observed similar results after 52 weeks of therapy (Bahcecioglu et al, 2015). Our model predicts an overall decline of HDV viremia after 12 months comparable to that achieved by some patients in the study by Guedj et al (2014); however there are some differences in the early decline, since our model predicts a monophasic rather than a biphasic decline.…”

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

“…Late Virologic Response (LVR) was the absence of detection of HDV RNA in the blood 48 weeks after treatment initiation [20,21].…”

Therapeutic Strategies and New Intervention Points in Chronic Hepatitis Delta Virus Infection

“…Numerous controlled clinical trials have been conducted since the early 1990s testing various interferon-containing treatment regimens in CHD subjects [ 39 ]. Despite these efforts, disappointing response rates were generally observed (~up to 43%) after a 1 to 2 year treatment course [ 40 , 41 , 42 , 43 ]. At least one large observational retrospective study is also closely aligned with this conclusion [ 43 ].…”