A Case Of Autoımmune Hepatitis Following Pegylated Interferon Treatment Of Chronic Hepatitis Delta

Enç, Feruze Yılmaz; Ulaşoğlu, Celal

doi:10.14744/nci.2019.47701

Cited by 5 publications

(7 citation statements)

References 12 publications

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“…56 Additional cases have been reported by others. 84,85 Thus, features of autoimmune hepatitis should be evaluated before an interferon-based treatment is considered in hepatitis D patients. However, the overall risk for worsening of autoimmune features seems to be low, and resolution of HDV may even reduce IgG levels as one feature possibly associated with autoimmunity.…”

Section: Safe T Y Of Interferon -Ba S Ed Antivir Al Tre Atment In Hep...mentioning

confidence: 99%

“…Subsequently, in the HIDIT‐I trial one patient had to stop treatment after 12 weeks when an underlying autoimmune hepatitis was demasked during pegylated interferon treatment 56 . Additional cases have been reported by others 84,85 . Thus, features of autoimmune hepatitis should be evaluated before an interferon‐based treatment is considered in hepatitis D patients.…”

Section: Safety Of Interferon‐based Antiviral Treatment In Hepatitis Dmentioning

confidence: 99%

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Interferon‐based treatment of chronic hepatitis D

Sandmann

Wedemeyer

2022

Liver International

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Treatment of hepatitis D virus (HDV) infection has been based on the administration of interferon‐alfa for more than three decades. First studies to treat HDV‐infected patients with type 1 interferons were already performed in the 1980s. Several smaller trials and case series were reported thereafter. During the mid 2000s the use of pegylated interferons for hepatitis D was established. Since then, additional trials were performed in different countries exploring strategies to personalize treatment including extended treatment durations. The overall findings were that about one‐quarter to one‐third of patients benefit from interferon treatment with persistent suppression of HDV replication. However, only few patients achieve also functional cure of hepatitis B with HBsAg loss. Importantly, several studies indicate that successful interferon treatment is associated with improved clinical long‐term outcomes. Still, only a proportion of patients with hepatitis D can be treated with interferons. Even though alternative treatments are currently developed, it is likely that pegylated interferon‐alfa will still have an important role in the management of hepatitis D – either alone or in combination. Therefore, better biomarkers are needed to select patients with a high likelihood to benefit from interferon‐based treatments. In this review we are discussing basic principles of mode of action of interferon alpha against HDV, summarize previous data on interferon treatment of hepatitis D and give an outlook on potential combinations with novel drugs currently in development.

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Section: Safe T Y Of Interferon -Ba S Ed Antivir Al Tre Atment In Hep...mentioning

confidence: 99%

Section: Safety Of Interferon‐based Antiviral Treatment In Hepatitis Dmentioning

confidence: 99%

Interferon‐based treatment of chronic hepatitis D

Sandmann

Wedemeyer

2022

Liver International

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“…In addition to this study, previous reports have shown a positive correlation between pegylated interferon treatment in HBV patients and the induction of AIH in approximately 25%-40%[ 17 ]. Furthermore, isolated cases of patients with hepatitis delta have shown that AIH is also observed after treatment with pegylated interferon[ 18 ]. In contrast, a case of HDV-RNA flare has been reported in a previously negative patient who received immunosuppressive treatment for AIH[ 5 ].…”

Section: Aih Induced By Hdvmentioning

confidence: 99%

Management of autoimmune hepatitis induced by hepatitis delta virus

Gigi,

Lagopoulos,

Liakos

2024

World J Gastroenterol

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Approximately 12-72 million people worldwide are co-infected with hepatitis B virus (HBV) and hepatitis delta virus (HDV). This concurrent infection can lead to several severe outcomes with hepatic disease, such as cirrhosis, fulminant hepatitis, and hepatocellular carcinoma, being the most common. Over the past few decades, a correlation between viral hepatitis and autoimmune diseases has been reported. Furthermore, autoantibodies have been detected in the serum of patients co-infected with HBV/HDV, and autoimmune features have been reported. However, to date, very few cases of clinically significant autoimmune hepatitis (AIH) have been reported in patients with HDV infection, mainly in those who have received treatment with pegylated interferon. Interestingly, there are some patients with HBV infection and AIH in whom HDV infection is unearthed after receiving treatment with immunosuppressants. Consequently, several questions remain unanswered with the challenge to distinguish whether it is autoimmune or “autoimmune-like” hepatitis being the most crucial. Second, it remains uncertain whether autoimmunity is induced by HBV or delta virus. Finally, we investigated whether the cause of AIH lies in the previous treatment of HDV with pegylated interferon. These pressing issues should be elucidated to clarify whether new antiviral treatments for HDV, such as Bulevirtide or immu-nosuppressive drugs, are more appropriate for the management of patients with HDV and AIH.

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“…Daher bleibt die Leberbiopsie zunächst der Goldstandard für die Beurteilung des Stadiums der Leberfibrose bei Patienten mit chronischer HDV-Infektion ohne eindeutige klinische, labortechnische oder bildgebende morphologische Anzeichen einer Leberzirrhose. Darüber hinaus kann eine Beurteilung der Leberhistologie wichtig sein, um Anzeichen einer autoimmunen Hepatitis vor der PEG-IFN-Therapie auszuschließen, die bei Hepatitis D auftreten kann [71] und eine Kontraindikation gegen die PEG-IFN-Therapie darstellt [52].…”

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