title: Efficacy of prolonged tenofovir therapy on hepatitis delta in HIV-infected patients.
abstract: BACKGROUND
  Hepatitis delta virus (HDV) produces the most severe form of chronic viral hepatitis. We explored whether prolonged tenofovir exposure might be beneficial on hepatitis delta in HIV-infected patients.
  
  
  METHODS
  All HIV-infected patients with hepatitis delta followed at our institution since year 2000 were retrospectively examined. Serum HBV-DNA and HDV-RNA were quantified using commercial assays. Liver fibrosis was measured using elastometry.
  
  
  RESULTS
  A total of 19 HIV/delta patients were identified. All were viremic for HDV and 11 for HBV. After a median tenofovir exposure of 58 months, all had undetectable HBV-DNA and 10 (53%) had undetectable HDV-RNA. The median drop in HDV-RNA in the remaining nine HDV viremic patients at the end of follow-up was 2.4 log copies/ml. A reduction above 30% in liver stiffness occurred in six out 10 (60%) patients who achieved undetectable HDV-RNA, whereas hepatic stiffness did not change in the remaining HDV viremic patients (P = 0.03). Serum HBsAg concentrations did not decline significantly, although HBsAg seroclearance occurred in three patients, all of whom became negative for HDV-RNA.
  
  
  CONCLUSIONS
  Long-term exposure to tenofovir significantly reduced serum HDV-RNA apart from completely suppressing HBV-DNA in HIV-infected patients with hepatitis delta. This virological benefit is accompanied by significant improvements in liver fibrosis.
authors.affiliation: aDepartment of Infectious Diseases, Hospital Carlos III bDepartment of Internal Medicine, La Paz University Hospital cDepartment of Internal Medicine, Puerta de Hierro Research Institute & University Hospital, Madrid, Spain.
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Eugenia
authors.initials: E
authors.lastname: Vispo
authors.forename: Rocío
authors.initials: R
authors.lastname: Sierra-Enguita
authors.forename: Carmen de
authors.initials: Cd
authors.lastname: Mendoza
authors.forename: José V
authors.initials: JV
authors.lastname: Fernández-Montero
authors.forename: Pablo
authors.initials: P
authors.lastname: Labarga
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D015658:HIV Infections / Q000150:complications*; D019701:Hepatitis D, Chronic / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage*; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D000068698:Tenofovir; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D012367:RNA, Viral; D000068698:Tenofovir; D000225:Adenine