Keshvari Maryam, Alavian Seyed Moayed, Sharafi Heidar, Karimi Gharib, Gholami Fesharaki Mohammad
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, IR Iran ; Middle East Liver Disease (MELD) Center, Tehran, IR Iran.
Middle East Liver Disease (MELD) Center, Tehran, IR Iran.
Hepat Mon. 2014 Mar 1;14(3):e15729. doi: 10.5812/hepatmon.15729. eCollection 2014 Mar.
Approximately 5% of hepatitis B virus (HBV) carriers are coinfected with hepatitis D virus (HDV). HBV/HDV coinfection is a major cause of cirrhosis and end stage liver disease in chronic HBsAg carriers. The only approved therapy for chronic hepatitis delta is interferon alpha (IFN α) in either pegylated or conventional forms. Although higher doses and longer durations of IFN α therapy in HBV/HDV coinfected patients are currently applied, yet treatment response is low.
We aimed to determine the efficacy of IFN α-2b therapy in patients with HBV/HDV coinfection.
In this cross sectional study, 20 HBsAg carriers with positive Anti-HDVAb and RT-PCR for HDV RNA were recruited and treated for three year duration with 5 million units (MU) of IFN α-2b, three times weekly or one year with 5 MU of IFN α-2b daily. Sustained virological response (SVR) was defined as a negative qualitative HDV RT-PCR, 6 months after treatment cessation.
Overall, 3 (15%) subjects achieved SVR, 10 cases (50%) relapsed after treatment cessation and 7 (35%) patients did not clear HDV during the treatment.
HDV coinfection with HBV had very low response rate to high doses and long durations of IFN α-2b therapy.
约5%的乙型肝炎病毒（HBV）携带者合并感染丁型肝炎病毒（HDV）。HBV/HDV合并感染是慢性HBsAg携带者肝硬化和终末期肝病的主要原因。目前唯一获批用于治疗慢性丁型肝炎的药物是聚乙二醇化或常规形式的干扰素α（IFNα）。尽管目前在HBV/HDV合并感染患者中应用了更高剂量和更长疗程的IFNα治疗，但治疗反应率较低。
我们旨在确定IFNα-2b治疗HBV/HDV合并感染患者的疗效。
在这项横断面研究中，招募了20名抗-HDVAb和HDV RNA的RT-PCR检测均为阳性的HBsAg携带者，用500万单位（MU）的IFNα-2b每周三次治疗三年，或用5 MU的IFNα-2b每日治疗一年。持续病毒学应答（SVR）定义为治疗停止后6个月HDV RT-PCR定性检测为阴性。
总体而言，3名（15%）受试者实现了SVR，10例（50%）在治疗停止后复发，7名（35%）患者在治疗期间未清除HDV。
HBV合并HDV感染对高剂量和长疗程的IFNα-2b治疗反应率非常低。
