title: Entecavir treatment of chronic hepatitis D.
abstract: BACKGROUND
  Hepatitis D virus (HDV) requires hepatitis B surface antigen (HBsAg) to propagate infection and cause disease. Entecavir is a nucleoside analog with potent antiviral efficacy, and in the woodchuck animal model it also decreased hepatitis B virus (HBV) cccDNA and woodchuck surface antigen. The aim of this study was to investigate the efficacy of entecavir in chronic hepatitis D (CHD).
  
  
  METHODS
  This single-center study was conducted in patients with compensated liver disease. All patients had to have detectable hepatitis HDV RNA and elevated levels of alanine aminotransferase (ALT). Entecavir was given at a dosage of 1 mg/d for 1 year. The primary end point was achievement of undetectable HDV RNA at the end of treatment.
  
  
  RESULTS
  Thirteen consecutive patients were assessed. All patients had detectable HDV RNA, and 8 had detectable HBV DNA at baseline. At the end of treatment, HBV DNA became undetectable in all patients (P = .001). No significant decline in HDV RNA, ALT, or quantitative HBsAg levels was observed. The primary end point of undetectable HDV RNA at the end of treatment was achieved in 3 patients who had significantly lower baseline HDV RNA levels than nonresponders (2.99 log(10) copies/mL ± .70 vs 4.68 ± .97; P = .0185). In all 3 patients, ALT levels were also normal at the end of treatment.
  
  
  CONCLUSIONS
  One year of entecavir treatment is ineffective in CHD. Any generalized beneficial effect of nucleoside/nucleotide analog treatment may necessitate prolonged treatment. Patients with CHD with HBV dominance, which is likely to occur in the later phases of CHD, may be a reasonable patient cohort in which to target nucleoside/nucleotide analog therapy.
authors.affiliation: Departments of Gastroenterology, University of Ankara Medical School, Dikimevi 06100, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kabaçam
authors.forename: F Oguz
authors.initials: FO
authors.lastname: Onder
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yakut
authors.forename: Gülseren
authors.initials: G
authors.lastname: Seven
authors.forename: Senem C
authors.initials: SC
authors.lastname: Karatayli
authors.forename: Ersin
authors.initials: E
authors.lastname: Karatayli
authors.forename: Berna
authors.initials: B
authors.lastname: Savas
authors.forename: Ramazan
authors.initials: R
authors.lastname: Idilman
authors.forename: A Mithat
authors.initials: AM
authors.lastname: Bozdayi
authors.forename: Cihan
authors.initials: C
authors.lastname: Yurdaydin
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019701:Hepatitis D, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; C413685:entecavir; D006147:Guanine; D000410:Alanine Transaminase