Treatment of chronic hepatitis D with thymus-derived polypeptide thymic humoral factor-gamma 2: a pilot study

Rosina, F.; Conoscitore, P.; Smedile, Antonina; Mangia, Alessandra; Borghesio, E.; Martinotti, R; Andriulli, Angelo; Rizzetto, Mario

doi:10.1016/s1590-8658(02)80149-9

Cited by 16 publications

(7 citation statements)

References 13 publications

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“…It has been reported as being effective in chronic hepatitis B. However, no virological or biochemical effect was seen in CHD [77]. The antihelminthic drug levamisole, because of its immunomodulatory properties, was also tried but was without effect in CHD [78].…”

Section: Current Treatment Of Chdmentioning

confidence: 99%

Natural history and treatment of chronic delta hepatitis

Yurdaydın

İdilman

Bozkaya

et al. 2010

Journal of Viral Hepatitis

143

130

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Chronic delta hepatitis (CDH) represents a severe form of chronic viral hepatitis, induced by the hepatitis delta virus (HDV) in conjunction with the hepatitis B virus (HBV). Delta hepatitis may lead to disease in humans through co-infection. The former leads to acute hepatitis which clinically can range from mild hepatitis to fulminant hepatitis and death. Severe or fulminant hepatitis is more often observed with HBV-HDV co-infection compared to HBV mono-infection. Chronic infection after acute hepatitis B + D co-infection is infrequent and similar to the rate in mono-infected patients. CDH develops in 70-90% of patients with superinfection. CDH runs a more progressive course than chronic hepatitis B and may lead to cirrhosis within 2 years in 10-15% of patients. However, as with any immune-mediated disease, different patterns of progression, ranging from mild to severe progressive disease, are observed. Active replication of both HBV and HDV may be associated with a more progressive disease pattern. Further, different HDV and HBV genotypes may contribute to various disease outcomes. CDH may be frequently associated with hepatocellular carcinoma development although recent studies provided conflicting results. The only established therapy for CDH is treatment with interferons for a duration of at least 1 year. On treatment, 6 month HDV RNA assessment may give clues as to whether to stop treatment at 1 year or continue beyond 1 year. New approaches to treatment of CDH are an urgent need of which the use of prenylation inhibitors appears the most promising.

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Section: Current Treatment Of Chdmentioning

confidence: 99%

Natural history and treatment of chronic delta hepatitis

Yurdaydın

İdilman

Bozkaya

et al. 2010

Journal of Viral Hepatitis

143

130

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“…53 In another study, thymic humoral factor-gamma 2, a thymus derived synthetic octapeptide, was used in 11 patients; HDV RNA became undetectable in three of eight patients with HDV RNA detectable at baseline, of whom two had a virologic relapse. 54 Thymus-derived peptides are believed to have a variety of immunomodulatory effects 55,56 and beneficial effects were reported using a combination of thymic humoral factor-gamma 2 with INFα in chronic hepatitis B 57 ; however, no combination was tested in CDH.…”

Section: What Is the Impact Of Therapy In The High Proportion Ofmentioning

confidence: 99%

Treatment of Chronic Delta Hepatitis

Yurdaydın¹

2012

Semin Liver Dis

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Chronic delta hepatitis (CDH) remains the most progressive form of chronic viral hepatitis and as such its successful treatment is important. However, in striking contrast to the situation in chronic hepatitis B and C, no new drugs for its treatment have been introduced in the recent past and interferons remain the only evidence-based effective treatment of CDH. However, results are far from optimal. Overall, around 25 to 30% of patients may have a sustained response after one year of conventional or pegylated interferon (Peg-INF) treatment and such treatment may favorably affect the natural history of the disease. The superiority of Peg-INF over its conventional form is possible, but has not been demonstrated in a clinical trial. Several unanswered questions remain in the context of INF treatment such as (1) the need for standardization of HDV-RNA quantitation, the most widely used surrogate marker of treatment efficacy; (2) validation of this treatment end point as an index of long-term containment of HDV; (3) optimal duration of treatment; (4) baseline and on-treatment parameters of treatment efficacy; and (5) development of new markers of treatment efficacy. Nucleos(t)ide analogs (NAs) have been widely tested in CDH, but they appear to be ineffective when used for a duration of up to 2 years. Combination treatment of NAs with INFs also proved to be disappointing. New approaches to treatment are hepatocyte entry inhibitors and prenylation inhibitors to be hopefully tested in human CDH in the not-too-distant future.

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“…However, although the biochemical response is usually accompanied by a transient virological response, there is a high rate (60–70%) of post‐treatment relapse 5, 6 . Aside from IFN, other therapeutic approaches, such as acyclovir, ribavirin and thymosin, have been unhelpful 7–9 …”

Section: Introductionmentioning

confidence: 99%

Lamivudine therapy in chronic delta hepatitis: a multicentre randomized‐controlled pilot study

Niro

Ciancio

Tillman

et al. 2005

Aliment Pharmacol Ther

Self Cite

105

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SUMMARYBackground: Delta virus (HDV)-related chronic hepatitis is difficult to treat. Aims: To evaluate the efficacy of lamivudine 100 mg daily on serum HDV-RNA, hepatitis D virus antibodies and alanine aminotransferase levels, liver histology, and on hepatitis B surface antigen seroconversion. Methods: Thirty-one hepatitis B surface antigen-positive, HDV-RNA-positive patients with ALT ‡ 1.5 upper normal level and compensated liver disease were randomized (1:2 ratio) to placebo (group A, n ¼ 11) or lamivudine (group B, n ¼ 20) for 52 weeks; thereafter, all patients were given lamivudine for 52 weeks and followed up for 16 weeks.

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Treatment of chronic hepatitis D with thymus-derived polypeptide thymic humoral factor-gamma 2: a pilot study

Cited by 16 publications

References 13 publications

Natural history and treatment of chronic delta hepatitis

Natural history and treatment of chronic delta hepatitis

Treatment of Chronic Delta Hepatitis

Lamivudine therapy in chronic delta hepatitis: a multicentre randomized‐controlled pilot study

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