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

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Yurdaydin C., Keskin O., Kalkan C., Karakaya F., Caliskan A., Kabacam G., ...Daha Fazla

JOURNAL OF INFECTIOUS DISEASES, sa.8, ss.1184-1192, 2018 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2018
  • Doi Numarası: 10.1093/infdis/jix656
  • Dergi Adı: JOURNAL OF INFECTIOUS DISEASES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1184-1192
  • Anahtar Kelimeler: Hepatitis B, interferon treatment, hepatocellular carcinoma, liver-related mortality, HBsAg clearance, HIV-INFECTED PATIENTS, HDV RNA RELAPSE, PEGYLATED INTERFERON-ALPHA-2B, COINFECTED PATIENTS, ALPHA THERAPY, VIRUS, TENOFOVIR, EFFICACY, REPLICATION, COMBINATION
  • Ankara Üniversitesi Adresli: Evet

Özet

Background. Interferon is the only treatment option in chronic delta hepatitis (CDH). A CDH database (333 patients, 161 with interferon treatment history) was analyzed for effects of treatment duration on virologic response and clinical outcomes. Methods. Ninety-nine CDH patients who received at least 6 months of interferon were selected. Maintained virologic response (MVR) was defined as hepatitis D virus RNA negative for 2 years after treatment discontinuation. Cumulative median interferon treatment duration was 24 months (range 6-126 months), with a median of 2 courses (range 1-8). Post-treatment median follow-up was 55 months (24-225 months). Results. Thirty-five patients achieved MVR. Cumulative probability of MVR increased with treatment duration and reached 50% at 5 years. Patients with MVR were less likely to die from liver disease or develop complications compared to patients without MVR (P = .032, P = .006, respectively). Cirrhosis at baseline and no response to therapy (odds ratio 16.1 and 5.23, respectively) predicted an adverse endpoint. Hepatitis B surface antigen clearance occurred in 37% of patients with MVR. Conclusion. 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.