title: Does interferon-sparing tenofovir disoproxil fumarate-based therapy have a role in the management of severe acute hepatitis delta superinfection?
abstract: Infection with hepatitis delta virus (HDV) always occurs in association with hepatitis B virus (HBV) and is a cause of significant morbidity and mortality. We present a case of severe acute HDV infection superimposed on a previously unrecognized HBV infection, in which an interferon-sparing antiviral therapy consisting of tenofovir disoproxil fumarate (TDF) and lamivudine was initiated and subsequently maintained. Evidence of successful suppression of HDV ribonucleic acid (RNA) was obtained after 65 weeks of TDF-based treatment. This was mirrored by a significant reduction in the levels of HBV DNA and HBV surface antigen. HDV RNA subsequently rebounded after our patient stopped antiviral therapy of his own accord. Interferon-sparing TDF-based antiviral therapy was safe and effective in achieving HDV RNA suppression in acute HDV superinfection. Further research into the utility of interferon-sparing TDF-based regimes in the treatment of acute HDV infection is needed.
authors.affiliation: Department of Infectious Diseases & Tropical Medicine, North Manchester General Hospital, Delaunays Road, Manchester M8 5RB, UK.
authors.forename: Zahir Osman Eltahir
authors.initials: ZOE
authors.lastname: Babiker
authors.affiliation: Department of Infectious Diseases & Tropical Medicine, North Manchester General Hospital, Delaunays Road, Manchester M8 5RB, UK.
authors.forename: Celia
authors.initials: C
authors.lastname: Hogan
authors.affiliation: Department of Infectious Diseases & Tropical Medicine, North Manchester General Hospital, Delaunays Road, Manchester M8 5RB, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ustianowski
authors.affiliation: Department of Infectious Diseases & Tropical Medicine, North Manchester General Hospital, Delaunays Road, Manchester M8 5RB, UK.
authors.forename: Edmund
authors.initials: E
authors.lastname: Wilkins
mesh_terms: D000208:Acute Disease; D000225:Adenine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D006509:Hepatitis B / Q000188:drug therapy*; D003699:Hepatitis D / Q000188:drug therapy*; D003698:Hepatitis Delta Virus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007372:Interferons; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D063065:Organophosphonates / Q000494:pharmacology / Q000627:therapeutic use*; D012367:RNA, Viral / Q000032:analysis; D015163:Superinfection / Q000188:drug therapy / Q000821:virology; D000068698:Tenofovir; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D012367:RNA, Viral; D019259:Lamivudine; D007372:Interferons; D000068698:Tenofovir; D000225:Adenine