Extended Interferon Treatment Not Helpful for Hepatitis Delta
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Interferon for the Treatment of Chronic Hepatitis Delta
www.hivandhepatitis.com
By Liz Highleyman
Hepatitis delta virus (HDV) is a defective virus-like pathogen that can only replicate in the presence of hepatitis B virus (HBV). HDV is transmitted through the same routes as HBV (direct blood contact, sexual contact, mother-to-child). People may either become coinfected with HBV and HDV at the same, or may acquire HDV while already infected with HBV.
A 1-year course of high-dose interferon alpha is the only established treatment for chronic HDV infection, but it has a high relapse rate after therapy is completed.
As reported in the November 2007 Journal of Viral Hepatitis, researchers from the University of Ankara in Turkey conducted a study to determine whether treating HDV for 2 years would improve sustained response rates.
In this study, 23 patients were treated with 10 million unit (MU) of interferon alpha-2b (Intron-A) 3 times weekly for 2 years. Treatment response was assessed as follows at the end of treatment (24 months) and after a 6-month follow-up period (30 months total):
- Virological response: undetectable HDV RNA;
- Biochemical response: normal alanine aminotransferase (ALT);
- Histological response: at least 2-point decrease in the Knodell score (histological activity index measuring liver necroinflammation and fibrosis).
Results
- 15 patients completed the 2-year course of treatment and 6-month follow-up period.
- Out of these patients, 7 (47%) had a biochemical response, but only 2 (13%) still had normal ALT at the end of follow-up.
- ALT decreased from the mean baseline value of 143.1 to 39.7 IU/L at the end of treatment.
- 6 patients had a virological response at the end of treatment, but only 2 had sustained virological response at the end of the follow-up period.
- 2 patients lost hepatitis B surface antigen (HBsAg).
- Among the 12 patients with paired liver biopsies, 8 experienced histological improvement.
Conclusion
Based on these findings, the authors concluded, “Interferon treatment leads to a complete or partial response in a substantial number of patients, but 2 years of treatment does not appear to increase sustained response rates over 1 year treatment.”
10/26/07
Reference
C Yurdaydin, H Bozkaya, H Karaaslan, and others. A pilot study of 2 years of interferon treatment in patients with chronic delta hepatitis. Journal of Viral Hepatitis 14(11): 812-816. November 2007.
