Z Gastroenterol 2006; 44 - A5_08
DOI: 10.1055/s-2006-931778

Treatment of chronic hepatitis delta with pegylated interferon-alfa2b – a pilot study

A Erhardt 1, W Gerlich 2, C Starke 1, U Wend 2, A Donner 3, A Sagir 1, T Heintges 1, D Häussinger 1
  • 1Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Düsseldorf
  • 2Institut für Medizinische Virologie, Universtitätsklinikum Gieesen, Giessen
  • 3Institut für Pathologie, Uniklinik Düsseldorf, Düsseldorf

Background and Aims: So far there is no effective treatment of chronic hepatitis D. The present pilot study addressed the question whether pegylated interferon-alfa2b is effective in chronic hepatitis D.

Patients and methods: Twelve patients with chronic hepatitis D were prospectively treated with 1.5µg/kg pegylated interferon-alfa2b for 48 weeks and followed for another 24 weeks. Sustained response (SR) was defined as undetectable HDV-RNA (by RT-PCR) and normalization of ALT at 6 months after treatment. Study investigations included HDV RNA kinetics, determination of HBV and HDV genotypes and histological evaluation.

Results: A sustained virological response was achieved in 2 out of 12 of patients (17%). The negative predictive value of a less than 3 log HDV RNA decrease at month 6 was 100%. The positive predictive value of a more than 3 log HDV RNA decrease at month 6 was 67%. A marked ALT reduction at the end of treatment was observed in responders and nonresponders. ISHAK histological score was comparable at baseline and significantly improved in responders compared to nonresponders at the end of follow up (13.5 vs. 8.0; p<0.02).

Conclusion: SR with pegylated interferon-alfa2b was higher than with standard interferons. Nonresponders could be identified by a less than 3 log decrease of HDV RNA at 6 months of treatment. Even virological nonresponders may benefit from IFN therapy due to a partial biochemical response and a suppression of histological progression.

Key words

hepatitis - HDV - interferon