Loss of HBsAg with interferon-alpha therapy in chronic hepatitis D virus infection.
Eleven patients with chronic hepatitis D virus (HDV) infection who had chronic active hepatitis and HDV antigen on liver biopsy were randomised in a crossover therapeutic trial of interferon-alpha 2b vs. no therapy. Nine patients had a history of intravenous drug use (drug free > 6 months before therapy), 8 had histological evidence of cirrhosis, and 7 out of 10 tested were found to be seropositive for antibody to hepatitis C virus (HCV). Six patients were randomised to receive interferon-alpha 2b therapy for 1 year, and 5 patients received no therapy for 1 year followed by the same regime of interferon-alpha 2b treatment. All patients with a history of intravenous drug use found self-injection stressful, 3 patients restarted using illicit drugs, and 2 patients with active cirrhosis developed severe thrombocytopenia during therapy and treatment was stopped in these patients. Of the 6 patients who completed at least 11 months of treatment, 4 lost serum hepatitis B surface antigen (HBsAg) with 3 developing antibody to HBsAg and one patient completing treatment. Among the 6 patients who had posttreatment liver biopsy, 5 showed an improvement in liver histology (3 of them lost serum HBsAg). These results provide further evidence that interferon-alpha is beneficial in chronic HDV infection although the psychological stress associated with the treatment, especially in patients with a previous history of intravenous drug use, is not inconceivable.
Institute of Liver Studies, King's College Hospital School of Medicine and Dentistry, London, United Kingdom.
J Y
JY
Lau
R
R
King
C J
CJ
Tibbs
A P
AP
Catterall
H M
HM
Smith
B C
BC
Portmann
G J
GJ
Alexander
R
R
Williams
D000328:Adult; D000956:Antigens, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D003699:Hepatitis D / Q000276:immunology / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000276:immunology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008099:Liver / Q000276:immunology; D008297:Male; D008875:Middle Aged
D000956:Antigens, Viral; D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha