Pegylated Interferon ? Therapy in Chronic Delta Hepatitis: A One-Center Experience

Abstract

Background: The only established therapy for chronic viral delta hepatitis, the most severe form of viral hepatitis is treatment with pegylated-interferon alpha (Peg IFN alpha). Objectives: In this study, we aimed to determine the efficacy of pegylated-interferon alpha 2a (Peg-IFN alpha 2a) and 2b (Peg IFN alpha 2b) in the treatment of patients infected with chronic delta hepatitis virus. Patients and Methods: The sample size was based on available patients potentially to be recruited. Data of 63 patients receiving either Peg IFN alpha 2a or Peg IFN alpha 2b were retrospectively assessed in the present cohort study performed in Turkey. Of 56 patients completed the study, 41 received Peg IFN alpha 2a and 15 received Peg IFN alpha 2b for 12 months. Patients were evaluated for biochemical and virological responses at the end of given treatment and six months after the treatment. Results: Stage of fibrosis was found high in both groups (85.4% vs. 86.7%), while cirrhosis was higher in the group of Peg IFN alpha 2b (53.3% vs. 34.1%). At the end of treatment, either hepatitis delta virus RNA (HDV RNA) alone or both HDV RNA and hepatitis b virus DNA (HBV DNA) had negative results in 32% of patients. Although HDV RNA negativity was sustained in 30.3% of patients, negativity of both HDV RNA and HBV DNA was decreased to 19.6% six months after completion of the treatment. HBV DNA became positive in one third of patients with response at six months after completion of the treatment (10.7 % of all patients). HDV RNA negativity at month six was found as a predictor of positive response. No significant difference was found between Peg IFN alpha 2a and Peg IFN alpha 2b for virological response rate. Conclusions: Treatment with Peg IFN alpha achieved a sustained negativity of HDV RNA in about one third of patients. Duration of Peg IFN alpha therapy might be prolonged to at least 24 months or more to prevent the occurrence of Hepatitis B virus (HBV) relapse encountered six months after completion of the treatment.