Interferon
for the Treatment of Chronic Hepatitis Delta) 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.
 | Hepatitis
Delta
Virus Image |
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. |
| FDA-approved
Monotherapies for HBV |
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