1. Resolution of chronic hepatitis Delta after 1 year of combined therapy with pegylated interferon, tenofovir and emtricitabine
- Author
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Françoise Lunel, Adeline Pivert, Frédéric Le Gal, Alexandra Ducancelle, Paul Calès, Wael Y. Mansour, Pierre Abgueguen, Emmanuel Gordien, Hélène Le Guillou-Guillemette, Centre national de référence des virus des hépatites B, C et Delta, Institut National de la Transfusion Sanguine [Paris] (INTS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Groupe hospitalier Henri-Mondor, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Service des maladies infectieuses et tropicales [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Université Paris 13 (UP13)-Institut National de la Transfusion Sanguine [Paris] (INTS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe hospitalier Henri-Mondor
- Subjects
Male ,HBsAg ,Hepatitis D, Chronic ,[SDV]Life Sciences [q-bio] ,Organophosphonates ,Interferon alpha-2 ,Antibodies, Viral ,Emtricitabine ,Antiviral Agents ,Deoxycytidine ,Polyethylene Glycols ,03 medical and health sciences ,0302 clinical medicine ,Tenofovir disoproxil fumarate ,Pegylated interferon ,Virology ,Humans ,Medicine ,Tenofovir ,Chronic hepatitis Delta ,030304 developmental biology ,Hepatitis ,0303 health sciences ,business.industry ,Adenine ,Seroconversion anti-HBs ,Interferon-alpha ,virus diseases ,Middle Aged ,Hepatitis B ,medicine.disease ,Hepatitis D ,Recombinant Proteins ,3. Good health ,Treatment Outcome ,Infectious Diseases ,HBeAg ,DNA, Viral ,RNA, Viral ,Drug Therapy, Combination ,030211 gastroenterology & hepatology ,Hepatitis Delta Virus ,business ,Viral load ,medicine.drug - Abstract
International audience; BackgroundHepatitis Delta virus (HDV) Infection has a worldwide distribution, with approximately 20 millions infected persons. Interferon (IFN) is the only approved drug for the treatment of HDV infection which is still a difficult to treat disease. Objectives To report a successful treatment of a patient with a chronic severe hepatitis Delta using combination therapy with Pegylated interferon (PegIFN), Tenofovir disoproxil fumarate (TDF) and Emtricitabine (FTC). Study Design The patient, a 47 years -old male patient, originating from Dagestan (East Asia), suffered of chronic hepatitis Delta infection. The patient was HBsAg, HBeAg, and anti-Delta Ab (IgG) positive. Serum HBV-DNA level was elevated (more than 9 logUI/mL). Serum HDV-RNA level was up to 5.6 log (copies/ml). Genotypes HBV/D and HDV-1 were demonstrated. The liver histology revealed chronic active hepatitis (Metavir score: A2F2). The treatment was started with PegIFN (180 μg/week) for two months and then TDF (300 mg/day) (combined later with FTC) was added. Results Sustained response was obtained after 10 months of treatment and was accompanied by the clearance of serum hepatitis B virus surface antigen with seroconversion to anti-HBs. Conclusion This case report suggests that Delta infection may co-exist with high replicative HBV infection and that combination therapy with PegIFN and nucleoside/tide analogues seems to be more effective than IFN alone. Given that only a single case is reported, further studies including more patients are warranted.
- Published
- 2010