title: HBsAg kinetics in chronic hepatitis D during interferon therapy: on-treatment prediction of response.
abstract: Therapy of chronic hepatitis D with Interferon is successful when testing for HDV-RNA turns negative. This end-point is disputed.
  
  
  
  To assess the role of serum hepatitis B surface antigen (HBsAg) in the clearance of HDV-RNA in pegylated interferon (Peg-IFN)-treated chronic hepatitis D (CHD).
  
  
  
  Sixty-two patients with CHD, treated with Peg-IFN, were considered. The patients belonged to three groups: 14 patients cleared the HBsAg and HDV-RNA (responders, R), 12 cleared the HDV-RNA remaining positive for HBsAg (partial responders, PR) and 36 cleared neither the HBsAg nor the HDV-RNA (nonresponders, NR).
  
  
  
  In responders, at baseline the median value (mv) of HBsAg and HDV-RNA was 1187 and 188 663 IU/mL. By month 6 of therapy, HBsAg declined to less than 1000 IU/mL and HDV-RNA was undetectable in 12 patients. In NR, the pre-therapy median value of HBsAg and HDV viremia was 6577 and 676 319 IU/mL. There was no significant reduction of antigen at month 6; after a decline, HDV-RNA rebounded to baseline levels. In PR, the median value of baseline HBsAg was 7031 IU/mL; it declined at month 6 in the majority. HDV-RNA progressively declined from an initial median value of 171 405 IU/mL. HBsAg <1000 IU/mL at month 6 discriminated responders and PR from NR (P < 0.001). By ROC curve, the threshold of 0.105 log reduction of HBsAg associated with 1.610 log reduction of HDV-RNA from baseline to month 6 predicted the clearance of this marker.
  
  
  
  A reduction of serum HBsAg is mandatory for the definitive clearance of the HDV-RNA. Quantitative HBsAg may predict the long-term response to Peg-IFN therapy and provide a guide to prolong or stop treatment.
authors.affiliation: Gastroenterology Unit, IRCCS 'Casa Sollievo Sofferenza' Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: G A
authors.initials: GA
authors.lastname: Niro
authors.affiliation: Department of Medical Sciences University of Turin, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Smedile
authors.affiliation: Gastroenterology Unit, IRCCS 'Casa Sollievo Sofferenza' Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: R
authors.initials: R
authors.lastname: Fontana
authors.affiliation: Department of Medical Sciences University of Turin, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Olivero
authors.affiliation: Department of Medical Sciences University of Turin, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ciancio
authors.affiliation: Gastroenterology Unit, IRCCS 'Casa Sollievo Sofferenza' Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Valvano
authors.affiliation: Microbiology and Virology Unit, A.O. Città della Salute e della Scienza, Molinette Hospital, University of Turin, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pittaluga
authors.affiliation: Department of Mental Health and Public Medicine, Second University of Naples, Caserta, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Coppola
authors.affiliation: Department for Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, German Center for Infection Research, Hannover, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wedemeyer
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Larissa, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Zachou
authors.affiliation: Internal Medicine and Hepatology, Second University of Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Marrone
authors.affiliation: Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fasano
authors.affiliation: IRCCS 'Casa Sollievo Sofferenza' Hospital, Blood Bank, San Giovanni Rotondo (FG), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Lotti
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Andreone
authors.affiliation: Gastroenterology Unit, IRCCS 'Casa Sollievo Sofferenza' Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Iacobellis
authors.affiliation: Gastroenterology Unit, IRCCS 'Casa Sollievo Sofferenza' Hospital, San Giovanni Rotondo (FG), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Andriulli
authors.affiliation: Department of Medical Sciences University of Turin, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rizzetto
mesh_terms: D000328:Adult; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D019701:Hepatitis D, Chronic / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology; D006801:Humans; D007167:Immunotherapy; D007372:Interferons / Q000627:therapeutic use*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D016896:Treatment Outcome; D014766:Viremia / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral; D007372:Interferons