title: Resolution of chronic hepatitis delta infection after five years of peginterferon-adefovir: lessons from a case report.
abstract: There is still some controversy about the treatment of hepatitis delta virus (HDV) infection and the treatment endpoints. A 48-year-old patient was treated with a combination of peginterferon-α and adefovir, and HDV RNA clearance occurred after 3 years of treatment. However, treatment was continued until HBs antigen (Ag) seroconversion, which occurred after 5 years of therapy. One year after the end of the treatment, the patient was still HBs Ag and HDV RNA negative. This case report suggests that combined peginterferon-α and adefovir may be effective in treating HDV infection and, if given over a longer period, may result in hepatitis B surface antigen (HBsAg) seroconversion. It highlights the interest of using HBsAg quantification associated with a sensitive RT-PCR approach for monitoring the treatment of chronic hepatitis delta. HBsAg seroconversion, or at least significant decrease, could be a more relevant endpoint than HDV RNA undetectability for discontinuing HDV treatment and preventing the occurrence of virological relapses.
authors: Department of Bacteriology-Virology-Hygiene, associated with the French National Reference Center for HDV, Avicenne Hospital, Paris 13 University, 125, rue de Stalingrad, 93009 Bobigny cedex, France. segolene.brichler@avc.aphp.fr
authors: Ségolène
authors: S
authors: Brichler
authors: Mashiko
authors: M
authors: Setshedi
authors: Christophe
authors: C
authors: Renou
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D004359:Drug Therapy, Combination; D019701:Hepatitis D, Chronic / Q000188:drug therapy*; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology; D035923:Hepatitis delta Antigens / Q000097:blood; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D035923:Hepatitis delta Antigens; D016898:Interferon-alpha; D063065:Organophosphonates; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C053001:adefovir; D000225:Adenine; C100416:peginterferon alfa-2a