Interferon Treatment Duration in Patients With Chronic Delta Hepatitis and its Effect on the Natural Course of the Disease

Yurdaydın, Cihan; Keskın, Onur; Kalkan, Çağdaş; Karakaya, Fatih; Çalışkan, Aysun; Kabaçam, Gökhan; Önder, Fatih; Karataylı, Senem Ceren; Karataylı, Ersin; Deda, Xheni; Bozkaya, Hakan; Bozdayı, A. Mithat; İdilman, Ramazan

doi:10.1093/infdis/jix656

Cited by 82 publications

(112 citation statements)

References 41 publications

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“…Treatment response is observed in around 25%‐40% after 1 year of treatment and extending treatment to 2 years does not appear to increase response rates . Still, there are data to suggest that IFN may need to be given for an extended duration of time, which is consistent with in vitro studies that appear to lend support for longer treatment duration . Viral kinetic studies also support the concept that CDH responds slower to IFN compared to hepatitis B (HBV) or hepatitis C virus (HCV) …”

mentioning

confidence: 58%

Optimizing lonafarnib treatment for the management of chronic delta hepatitis

Yurdaydın¹,

Keskın²,

Kalkan³

et al. 2018

Hepatology

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129

106

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The cytochrome P450 3A4 inhibitor, RTV, allows a lower LNF dose to be used while achieving higher levels of postabsorption LNF, yielding better antiviral responses and tolerability. In addition, combining LNF with PEG-IFNα achieved more substantial and rapid HDV-RNA reduction, compared to historical responses with PEG-IFNα alone. Twelve weeks of LNF can result in posttreatment HDV-RNA negativity in some patients, which we speculate results from restoring favorable immune responses. These results support further development of LNF with RTV boosting and exploration of the combination of LNF with PEG-IFN. (Hepatology 2018;67:1224-1236).

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mentioning

confidence: 58%

Optimizing lonafarnib treatment for the management of chronic delta hepatitis

Yurdaydın¹,

Keskın²,

Kalkan³

et al. 2018

Hepatology

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129

106

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“…In several studies, a variable percentage of patients ranging from 17% to 47% achieved undetectable HDV‐RNA levels by the end of treatment . Many of these patients relapsed during follow‐up; hence, the overall response was suboptimal . In addition, interferon has important adverse effects and contraindications that limit its use .…”

Section: Introductionmentioning

confidence: 99%

Long‐term clinical outcomes in patients with chronic hepatitis delta: the role of persistent viraemia

Palom

Rodríguez‐Tajes

Navascués

et al. 2019

Aliment Pharmacol Ther

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Summary Background Chronic hepatitis delta is a severe liver disease with rapid progression to cirrhosis. The impact of hepatitis delta virus (HDV)‐RNA on disease progression and interferon treatment in a real‐world cohort has been barely explored. Aim To assess the development of clinical events in a cohort of chronic hepatitis delta patients according to the presence or absence of HDV‐RNA Methods Multicentre study at four academic hospitals in Spain included anti‐HDV‐positive patients with compensated liver disease with a follow‐up ≥12 months. Results Among 2888 HBsAg‐positive subjects, 151 (5.2%) tested positive for anti‐HDV, and 118 were included (58% men; median age, 49 years; 73% detectable HDV‐RNA and 30% cirrhosis, most often in subjects with HDV‐RNA). After a median follow‐up of 8 years, subjects with initially detectable HDV‐RNA were more prone to developing cirrhosis (31% vs 0%, P = .002) and/or liver decompensation (28% vs 3%, P = .019). Mortality rate was 0.44 per 1000 person‐months. The probability of a clinical event was 6%, 25%, and 80% according to initial baseline‐event‐anticipation score. HDV‐RNA became undetectable in 21 (24%) subjects either due to interferon or spontaneously (48% vs 52%, P = .29). Liver decompensation was reduced in interferon‐treated patients (13% vs 38%, P = .026). Conclusions Subjects with persistently positive HDV‐RNA had a worse prognosis in terms of clinical events. Baseline‐event‐anticipation score is useful in predicting the risk of developing liver decompensation and hepatocellular carcinoma. Interferon was beneficial in reducing liver decompensation, even in the absence of virological response.

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“…Various studies have been performed with the hypothesis that two years of treatment would be superior to one, but these did not yield the anticipated results. Meanwhile, expert opinions and certain case presentations and some previous studies suggested that that some patients might be benefit from long-term treatment (30)(31)(32)(33). In a retrospective study focusing on the delta hepatitis database of Ankara University School of Medicine, increasing the duration of treatment was shown to increase cumulative treatment response rates as well (33).…”

Section: Treatment Patients With Cdhmentioning

confidence: 97%

“…Patients who respond to treatment have lower rates of developing cirrhosis, lower need to LT and lower hepatic diseaserelated mortality compared to those who do not respond (33).…”

Section: Treatment Patients With Cdhmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis, management and treatment of hepatitis delta virus infection: Turkey 2017 Clinical Practice Guidelines

Yurdaydın

Tabak

Kaymakoğlu

et al. 2017

Turk J Gastroenterol

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Interferon Treatment Duration in Patients With Chronic Delta Hepatitis and its Effect on the Natural Course of the Disease

Abstract: Viral response to interferon increases with treatment duration and favorably affects the natural course of disease. Interferon treatment duration has to be individualized with careful post-treatment assessment.

Cited by 82 publications

References 41 publications

Optimizing lonafarnib treatment for the management of chronic delta hepatitis

Optimizing lonafarnib treatment for the management of chronic delta hepatitis

Long‐term clinical outcomes in patients with chronic hepatitis delta: the role of persistent viraemia

Diagnosis, management and treatment of hepatitis delta virus infection: Turkey 2017 Clinical Practice Guidelines

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