Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 28, 2012; 18(40): 5793-5798
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5793
Treatment of chronic hepatitis delta virus with peg-interferon and factors that predict sustained viral response
Shaikh Samiullah, Devrajani Bikharam, Nasreen
Shaikh Samiullah, Devrajani Bikharam, Nasreen, Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad 71000, Pakistan
Author contributions: Samiullah S proposed the study and is the guarantor; Samiullah S and Bikharam D performed research and wrote the first draft; Nasreen collected and analyzed the data; all authors contributed to the design and interpretation of the study and to further drafts.
Supported by Hepatitis Prevention and Control Program Sindh, Pakistan Chief Minister’s initiative, a government organization provided peg-interferon treatment to patients for 48 wk free of cost
Correspondence to: Dr. Shaikh Samiullah, Associate Professor, Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad 71000, Pakistan. shaikhsamiullah@yahoo.com
Telephone: +92-300-3019233 Fax: +92-22-9213306
Received: April 8, 2012
Revised: July 27, 2012
Accepted: July 29, 2012
Published online: October 28, 2012
Abstract

AIM: To observe the efficacy of peg-interferon in the treatment of hepatitis delta virus (HDV) and to identify the factors that would be predictive of the sustained viral response (SVR).

METHODS: This prospective study was conducted in Medical Unit IV of the Liaquat University of Medical and Health Sciences Hospital Jamshoro from June 2008 to September 2011. This study cohort included all patients of either sex who presented during this time with hepatitis B surface antigen positivity, hepatitis B virus DNA > 20 000 IU/mL, serum glutamic pyruvic transaminase (SGPT) > 2(upper limit of normal), HDV-RNA positivity with fibrosis stage ≥ 2. Informed consent was obtained from each of these individuals. Patients were diagnosed with hepatitis D on the basis of detectable viral antibodies and the presence of HDV-RNA in their serum. A liver biopsy was performed in all cases and fibrosis staging was performed in accordance with the METAVIR scoring system. All eligible patients were administered peg-interferon at a weekly dosage of 1.5 μg/kg body weight for 48 wk. HDV-RNA was assayed at the end of this treatment period and again at 24 wk later. A biochemical response was determined by a normalization of SGPT at the end of the treatment or during follow up. The end of treatment response was defined by a HDV-RNA negative status. A sustained virological response was defined by undetectable serum HDV-RNA at six months after the end of treatment.

RESULTS: Among the 277 patients enrolled in our present study, 238 completed a course of peg-interferon therapy of which 180 (75.6%) were male and 58 (24.4%) female. Biochemical responses were achieved in 122/238 (51.3%) patients. End of treatment responses were achieved in 71/238 (29.8%) cases. A SVR was achieved in 70 of these patients (29.4%). A strong association was found between the SVR and the end of treatment responses (P = 0.001), biochemical responses (P = 0.001) and the degree of fibrosis (P = 0.002).

CONCLUSION: Peg-interferon therapy can induce remission in nearly one third of patients harboring HDV.

Keywords: Hepatitis D; Peg-interferon; Biochemical response