Single (B or C), dual (BC or BD) and triple (BCD) viral hepatitis in HIV-infected patients in Madrid, Spain

Arribas, José Ramón; González-García, Juan; Lorenzo, Andrea Di; Montero, Denise Carolina na Valdivia; Guevara, Concepción Ladrón de; Montes, Marisa; Hernández, Susana; Pacheco, Raquel S.; Peña, José M.; Vázquez, J. J.

doi:10.1097/01.aids.0000180787.10553.b2

Cited by 55 publications

(39 citation statements)

References 10 publications

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“…34 Chronic HDV was recognized in 14% of HIV-positive patients with chronic hepatitis B in EuroSIDA. This rate is lower than in other series which included more IDUs, 35 as more than half (51%) of HBsAg-positive patients in EuroSIDA were MSM, and IDUs only represented a quarter of patients. Delta hepatitis occurred more frequently in HBsAg-positive patients carrying non-A HBV genotypes than in those infected with genotype A (37% versus 6%, respectively), most probably because there was a strong segregation of HBV genotypes by risk group category.…”

Section: Discussioncontrasting

confidence: 59%

Predictors of hepatitis B virus genotype and viraemia in HIV-infected patients with chronic hepatitis B in Europe

Soriano

Mocroft

Peters

et al. 2010

Journal of Antimicrobial Chemotherapy

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Background: Both natural history and treatment outcome of hepatitis B virus (HBV) infection are influenced by genotypes and viral load. Information about factors determining HBV genotype distribution and viraemia in HIV/HBV-co-infected patients is scarce.Methods: All HIV-positive patients living in Europe and Argentina recruited in EuroSIDA (1994EuroSIDA ( -2006 were tested for serum HBV surface antigen (HBsAg). Chronic carriers were further characterized virologically at one central laboratory. Variables influencing HBV genotype distribution and viraemia were assessed using logistic regression.Results: From 16 505 HIV patients enrolled in EuroSIDA, 1179 (7.1%) were HBsAg positive, of whom 474 had specimens that allowed inclusion in the virological substudy. Overall 293 (62%) were treated with anti-HBV active antiretroviral drugs at the time of testing. Hepatitis delta virus superinfection was recognized in 14% and hepatitis C virus (HCV) antibodies in 27%. Serum HBV DNA was detectable in 315 (66.5%) and HBV genotyping gave results in 170 (35.9%) patients. HBV genotype distribution was as follows: A (72.9%), D (17.1%), G (1.8%), E (1.2%), F (1.2%) and C (0.6%); another 5.9% were co-infected with multiple HBV genotypes. In the multivariate analysis, the best predictor of HBV genotype A infection was risk exposure other than intravenous drug use, whereas predictors for detectable HBV viraemia were lower CD4 counts and lack of HCV antibodies. Conclusion:A substantial proportion of HIV-positive patients with chronic hepatitis B show detectable HBV viraemia despite being treated with anti-HBV active antiretroviral drugs (mainly lamivudine). Low CD4 counts were associated with an independent higher risk of detectable HBV viraemia, which supports an earlier introduction of antiretroviral therapy, including anti-HBV drug(s) more potent than lamivudine.

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Section: Discussioncontrasting

confidence: 59%

Predictors of hepatitis B virus genotype and viraemia in HIV-infected patients with chronic hepatitis B in Europe

Soriano

Mocroft

Peters

et al. 2010

Journal of Antimicrobial Chemotherapy

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“…Injection drug use being the most probable route of HDV transmission for the majority of patients included in our study, HCV infection was also present in many of them. The complex interplay between HBV, HCV and HDV has been described in several previous reports which generally showed HDV to be the dominant virus, often leading to the suppression of HBV as well as HCV 17,22,23 . In line with these findings, only 20% of HIV/HBV/HDV-coinfected patients and 10% of HIV/HBV/HDV-coinfected patients with replicating HDV in our cohort had a replicating HCV infection compared to 60% of HDV-negative individuals.…”

Section: Discussionmentioning

confidence: 86%

Hepatitis delta-associated mortality in HIV/HBV-coinfected patients

Béguelin

Moradpour

Sahli

et al. 2017

Journal of Hepatology

113

119

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“…The role of HDV on HCV replication is not well known, but previous studies have indicated a possible inhibition of HCV by HDV. 21 The absence of HCV re-activation in the sustained responders group is probably indicative of a favorable outcome of a past HCV infection in these patients.…”

Section: Characteristics Of the Patients At Baselinementioning

confidence: 95%

Efficacy of peginterferon alpha-2b in chronic hepatitis delta: Relevance of quantitative RT-PCR for follow-up

et al. 2006

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Hepatitis delta virus (HDV) can cause severe acute and chronic liver disease in patients infected by hepatitis B virus. Interferon alpha at high doses, although poorly efficient, is the only treatment reported to provide some benefit in chronic hepatitis delta. Pegylated interferon alpha (PEG-IFN) has not yet been evaluated. Treatment is usually monitored by the qualitative detection of HDV-RNA in serum. In this study, safety and efficacy of PEG-IFN were assessed in chronic hepatitis delta, and serum HDV-RNA kinetics were determined using quantitative RT-PCR. Fourteen patients with chronic hepatitis delta received subcutaneous PEG-IFN alpha-2b during 12 months (1.5 g/kg per week). Serum HDV-RNA was quantified at initiation and during the course of therapy, and during the posttreatment follow-up period, which ranged from 6 to 42 months (median 16 months). PEG-IFN alpha-2b was well tolerated, inducing no serious adverse effect. Sustained biochemical response was obtained in 8 patients (57%). At the end of treatment, 8 patients (57%) had achieved virological response (undetectable HDV-RNA). Sustained virological response throughout the posttreatment follow-up period was observed in 6 patients (43%). HDV-RNA kinetics were predictive of the response: after 3 months of PEG-IFN, HDV-RNA levels were significantly lower in the responders than in the nonresponders group (P ‫؍‬ .018). After 6 months of therapy, a negative HDV-RNA was predictive of sustained response (P ‫؍‬ .021). In conclusion, this preliminary study indicates that PEG-IFN alpha-2b is safe and efficient for treatment of chronic hepatitis delta. H epatitis delta virus (HDV) is a satellite RNA virus, which depends on the hepatitis B virus (HBV) for virion assembly and propagation. 1 HDV infection can cause severe acute and chronic liver disease, with a chronicity rate reaching 70% to 90% in cases of super-infection, 1-3 and a common progression to cirrhosis (60%-70%) accounting for frequent evolution to end-stage liver disease and hepatocellular carcinoma. 4,5 To date, treatment of chronic hepatitis delta relies on interferon alpha (IFN), but the efficacy is limited. 6 Antiviral drugs such as ribavirin, acyclovir, or famcyclovir are inefficient, 7,8 and anti-HBV drugs such as lamivudine, which efficiently reduce HBV viremia but not HBsAg levels have no effect on hepatitis delta, 9 even when associated to IFN. 10 Clevudine, which induces a reduction in the covalently closed circular DNA replication template levels could be useful in the treatment of chronic hepatitis delta but has only been evaluated in the woodchuck model for this indication. 11 The pegylated form of IFN (PEG-IFN), which has been proved to be more efficient than standard IFN in chronic hepatitis B and C, might improve the outcome of chronic hepatitis delta, but such treatment has not yet been evaluated. 12,13 The diagnosis of HDV infection usually relies on the detection of specific anti-HDV antibodies, with the presence of anti-HDV IgM reflecting ongoing viral replication. However, serologi...

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Single (B or C), dual (BC or BD) and triple (BCD) viral hepatitis in HIV-infected patients in Madrid, Spain

Abstract: In our geographic area approximately 5% of HIV infected patients with hepatitis suffer multiple hepatitis virus infection. In patients with triple hepatitis BCD virus infection, HDV appears to be the dominant virus causing inhibition of both HBV and HCV replication.

Cited by 55 publications

References 10 publications

Predictors of hepatitis B virus genotype and viraemia in HIV-infected patients with chronic hepatitis B in Europe

Predictors of hepatitis B virus genotype and viraemia in HIV-infected patients with chronic hepatitis B in Europe

Hepatitis delta-associated mortality in HIV/HBV-coinfected patients

Efficacy of peginterferon alpha-2b in chronic hepatitis delta: Relevance of quantitative RT-PCR for follow-up

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