title: Can antiretroviral therapy modify the clinical course of HDV infection in HIV-positive patients?
abstract: BACKGROUND
  Infection with hepatitis delta virus (HDV) affects approximately 6-14.5% of patients coinfected with HIV-1 and HBV, showing a more aggressive clinical course compared with an HIV-negative population. There is no universally approved treatment for chronic hepatitis D (CHD) in HIV-infected patients. Antiretroviral therapy (ART) containing tenofovir has been recently associated with HDV suppression. Our aim was to evaluate whether the outcome of CHD in HIV-infected patients can be favourably influenced by ART including reverse transcriptase inhibitors.
  
  
  METHODS
  The clinical course of four HBV/HDV/HIV-coinfected patients receiving ART were retrospectively examined.
  
  
  RESULTS
  HDV RNA became undetectable in all patients after a variable period of ART along with the disappearance of hepatitis B surface antigen in two of them, and an increase in CD4(+) T-cell count. In all patients, virological changes were associated with improved liver function tests and clinical features.
  
  
  CONCLUSIONS
  We suggest that ART regimens including drugs active against HBV could have beneficial effects on the clinical course of CHD in patients with HIV-1 by favouring immunological reconstitution.
authors.affiliation: Center for the Study of Liver Diseases, Department of Medical Sciences 'Mario Aresu', University of Cagliari, Cagliari, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Onali
authors.forename: Francesco
authors.initials: F
authors.lastname: Figorilli
authors.forename: Cinzia
authors.initials: C
authors.lastname: Balestrieri
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Serra
authors.forename: Maria
authors.initials: M
authors.lastname: Conti
authors.forename: Rosetta
authors.initials: R
authors.lastname: Scioscia
authors.forename: Lucia
authors.initials: L
authors.lastname: Barca
authors.forename: Maria E
authors.initials: ME
authors.lastname: Lai
authors.forename: Luchino
authors.initials: L
authors.lastname: Chessa
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006509:Hepatitis B / Q000175:diagnosis / Q000821:virology; D003699:Hepatitis D / Q000175:diagnosis / Q000821:virology*; D003698:Hepatitis Delta Virus; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D015415:Biomarkers