Treatment of chronic hepatitis D virus infection with low and high doses of interferon-α2a: Utility of polymerase chain reaction in monitoring antiviral response

Madejón, Antonio; Cotonat, Teresa; Bartolomé, Javier; Castillo, Inmaculada; Carréño, Vicente

doi:10.1002/hep.1840190602

Cited by 66 publications

(44 citation statements)

References 15 publications

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“…The diagnosis of HDV infection usually relies on the detection of specific anti-HDV antibodies, with the presence of anti-HDV immunoglobulin M (IgM) reflecting ongoing viral replication. However, the serological approach for the detection of virus replication lacks sensitivity (8,25). The HDV antigen is rarely detected in the serum, except in cases of acute infections (prior to the antibody response) or chronic infections in severely immunosuppressed patients (17).…”

mentioning

confidence: 99%

Quantification of Hepatitis Delta Virus RNA in Serum by Consensus Real-Time PCR Indicates Different Patterns of Virological Response to Interferon Therapy in Chronically Infected Patients

et al. 2005

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Hepatitis delta virus (HDV), in association with hepatitis B virus, is responsible for severe acute and chronic hepatitis. Treatment of the infection relies on the long-term administration of high doses of alpha interferon (IFN), and the treatment efficiency is monitored by the detection of anti-HDV immunoglobulin M and HDV genome in serum. Like the case for other chronic viral infections, HDV genome quantification in serum should be useful for the follow-up of infected patients. The aims of this study were to develop a quantitative assay for the detection of any type of HDV in serum and to evaluate the benefit of HDV RNA quantification for the follow-up of chronically infected patients receiving IFN. A real-time reverse transcription-PCR assay was developed to quantify the HDV RNA load in serum. Its efficacy was evaluated with 160 serum samples, 76 of which were collected from 11 chronically infected patients who were treated with pegylated IFN. The assay was sensitive (100 copies/ml of serum) and efficient for all HDV types, including type 3 and the recently described types 5, 6, and 7. The viral load determinations for treated patients allowed us to identify different profiles of virological responses to IFN therapy with more accuracy than that attainable with the qualitative approach. In conclusion, we have developed a quantitative HDV RNA assay for serum which is adapted to the follow-up of antiviral treatment for patients infected with any HDV type. The assay will help us to understand the natural history of HDV infection and to define guidelines for the management of chronic delta hepatitis.

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confidence: 99%

Quantification of Hepatitis Delta Virus RNA in Serum by Consensus Real-Time PCR Indicates Different Patterns of Virological Response to Interferon Therapy in Chronically Infected Patients

et al. 2005

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“…At present, interferon is the only option for the treatment of chronic hepatitis D. Since most patients have advanced disease and cirrhosis, the response rate to interferon (IFN) therapy is not high (less than 10% with 1-year IFN therapy [63][64][65]). Therapeutic efficacy increases when higher dose of interferon alpha is administered for prolonged periods (12-24 months) [63][64][65][66]. As described in an interesting case report a 12-year high-dose IFN treatment resulted in the complete resolution of HDV infection with remission of liver fibrosis and disappearance of HBV and HDV from serum [67].…”

Section: Current Therapiesmentioning

confidence: 92%

Delta Hepatitis

Günşar

2012

RHC

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Hepatitis delta virus (HDV) is a defective RNA virus that requires HBsAg for replication and transmission. It can cause acute or chronic hepatitis. Chronic infection with HDV is one of the most severe and difficult to treat forms of viral hepatitis. It has been estimated that there is a total of 15-20 million HDV carriers in the world. This review focuses on two fundamental aspects of HDV infection. On the one hand, epidemiological data are summarized, which are essential to understand the real burden of this disease. After the HBV vaccination programs in many countries all over the world, HDV infection has decreased since 1980’s but this decline has not continued further in the last decade. Therefore, HDV infection is still an important public health problem in the world. On the other hand, therapeutic options are described. Currently, interferons are the only option for the treatment of chronic hepatitis delta infection, and pegylated-interferons have shown better results than conventional interferons (IFNs). Monotherapy of nucleos(t)ide analogs have been found ineffective against the HDV infection, but adefovir and pegylated-IFN combination therapy have had some advantages for reduction of HBsAg levels. Trials with more potent nucleoside analogs and pegylated-IFN could be effective in the treatment of chronic HDV infection. New agents like prenylation inhibitors, that can affect the interactions between the large HDV antigen and HBsAg in the HDV virion, will be a hope in treatment of HDV infection.

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“…Traditionally, conventionally IFN proofed to be effective in chronic hepatitis D in the early 1990s [32][33][34][35] . Also, a placebo-controlled trial reported in 2005 could show a benefit for conventional IFN in a small cohort [36] .…”

Section: Treatment Of Delta Hepatitismentioning

confidence: 99%