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Extended Interferon Treatment Not Helpful for Hepatitis Delta

November 23, 2007

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While most cases of chronic viral hepatitis present a treatment challenge, treating the Hepatitis Delta virus is even harder. Soured by its high relapse rate, the only approved treatment for this infection is one year of interferon therapy. In their search for better solutions, Turkish researchers found that doubling the treatment length has no effect on this viral strain's response rates.

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.

Posted by Editors at November 23, 2007 2:22 PM