Treatment of chronic hepatitis D virus infection with low and high doses of interferon-α2a: Utility of polymerase chain reaction in monitoring antiviral response

✍ Scribed by Antonio Madejón; Teresa Cotonat; Javier Bartolomé; Inmaculada Castillo; Dr. Vicente Carreño

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 633 KB
• Volume: 19
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840190602

✦ Synopsis

We examined the efficacy of decreasing high doses (beginning at 18 MU/day) of interferon-%, vs. that of daily low doses (3 MU) in the treatment of chronic hepatitis delta virus infection. Patients treated with 18 MU had a somewhat higher frequency of normalization of serum ALT levels than patients treated with low doses (31% and 12%, respectively, on an intention-totreat basis). A decrease in the percentage of hepatitis D virus RNA positivity was observed in both groups at the end of treatment. Thus, whereas in baseline samples 10 (62%) of the patients in each group were positive for hepatitis D virus RNA in serum on slot-blot hybridization, these numbers decreased to 5 (31%) and4 (25%) patients in group 1 and 2, respectively, at the end of therapy. However, hepatitis D virus RNA, detected by means of nested polymerase chain reaction, remained in all but two (one in each group) patients who completed the treatment. Finally, during posttreatment follow-up, hepatitis D virus RNA levels returned to baseline values, and only one patient remained negative for this marker. The beneficial effect of interferon-a was only transient. Only two patients (one from each treatment group) had persistently normal serum ALT levels after 18 mo of follow-up. Finally, the presence of serum hepatitis D virus RNA at the end of therapy, detected with nested polymerase chain reaction, might be a good marker for the prediction of viral replication relapse. (HEPATOLOGY 1994;19:1331-1336.) Chronic hepatitis delta virus (HDV) infection is a progressive disease that can lead to cirrhosis (1). Interferon-a (IFN-a) is a proinflammatory cytokine with a wide range of biological activities that has been proved to be useful in the treatment of this disease. In pilot studies using low doses of IFN (3 to 5 MU), administered daily (2, 3) or three times a week (4) for short periods