title: Treatment of hepatitis delta virus genotype 3 infection with peg-interferon and entecavir.
abstract: OBJECTIVE
  Hepatitis delta virus (HDV) is recognized as the most pathogenic and infectious among the hepatotropic viruses. Studies on the treatment of HDV have predominantly included European patients and carriers of genotype 1 (HDV-1) in their clinical protocols. For the Amazon region, data show that infected individuals have mainly Native American ancestry and that >90% of HDV carriers have the genotype 3 (HDV-3). Thus combined therapy clinical protocols do not adequately address the treatment of these patients.
  
  
  METHODS
  A prospective, non-randomized study was conducted in which 22 patients received 180μg of pegylated interferon alpha 2a (PEG-IFN) plus entecavir at a dose of 0.5mg for 48 weeks, with a subsequent 24-week follow-up. Throughout treatment, the patients were monitored for biochemical responses and the kinetics of hepatitis B virus (HBV) and HDV viral loads.
  
  
  RESULTS
  Of the 22 patients treated, 15 presented normal alanine aminotransferase values at the end of treatment (p=0.002). At week 24 of treatment, 86.4% of the patients did not present detectable HDV-RNA; at week 48, the rate of negative patients increased to >95% and remained the same after 6 months. With regard to HBV, only two patients (9%) still presented detectable HBV genetic material at the end of treatment, suggesting the effectiveness of combined therapy in combating the two viruses.
  
  
  CONCLUSIONS
  These findings support the use of this effective therapeutic protocol for HDV-3 in patients of non-European ethnicity and suggest a possible 'easy to treat' variant when compared to HDV-1.
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil.
authors.forename: Lourdes Maria Pinheiro
authors.initials: LM
authors.lastname: Borzacov
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil.
authors.forename: Larissa Deadame
authors.initials: LD
authors.lastname: de Figueiredo Nicolete
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil.
authors.forename: Luan Felipo Botelho
authors.initials: LF
authors.lastname: Souza
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil.
authors.forename: Alcione Oliveira
authors.initials: AO
authors.lastname: Dos Santos
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil.
authors.forename: Deusilene Souza
authors.initials: DS
authors.lastname: Vieira
authors.affiliation: Research Center for Tropical Medicine of Rondônia - CEPEM/SESAU, and Federal University of Rondônia - UNIR, Rua da Beira, 7671 -BR364, Km 3.5 Bairro Lagoa, Porto Velho, Rondônia, Brazil. Electronic address: juanitto2001@yahoo.com.br.
authors.forename: Juan Miguel Villalobos
authors.initials: JM
authors.lastname: Salcedo
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003699:Hepatitis D / Q000188:drug therapy* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D011994:Recombinant Proteins / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; C100416:peginterferon alfa-2a
keywords: Entecavir; Genotype 3; HDV; PEG-IFN; Treatment