Study demonstrates benefits of existing treatment for hepatitis D patients

The study, presented at The International Liver CongressTM 2016 in Barcelona, Spain, demonstrated that 35% of patients with Hepatitis delta who responded to IFNa based therapies achieved sustained suppression of the virus and had favourable outcomes compared to those untreated or treated with nucleos(t)ide analogues (NUCs are a treatment option in Hepatitis B).

Hepatitis delta infections can only occur in those who are infected with Hepatitis B.1 This dual infection is a very severe form of viral hepatitis and can result in a more serious disease and worse outcome.2 According to the EASL guidelines, pegylated interferon is the only treatment effective against Hepatitis delta.3

"There has been significant debate over whether there are long-term benefits to patients with Hepatitis delta receiving antiviral treatment," said Anika Wranke, Fellow of Hannover Medical School, Germany and lead author of the study. "Our study demonstrates that the long-term outcomes for patients with severe Hepatitis delta, who have limited treatment options, could be improved with a widely available medication."

The German study authors selected 136 individuals with chronic Hepatitis delta who were followed for at least six months and conducted follow-up for a median of five years. Clinical endpoints, which included; ascites (fluid accumulation causing abdominal swelling), encephalitis (a serious condition that causes inflammation in the brain), esophageal bleeding (enlarged veins that bleed in the esophagus), liver cancer (hepatocellular carcinoma), liver transplant or death, were present in 40% of patients at baseline. According to study results, clinical endpoints were less frequent in patients who received IFNa-based therapies compared to those treated with NUCs or given no treatment at all. Out of the 52 patients treated with IFNa based therapies in the study, 18 (35%) achieved sustained suppression of Hepatitis delta.

"This study is evidence of the great progress being made in finding effective treatment strategies for Hepatitis delta sufferers," says Professor Tom Hemming Karlsen, EASL Vice-Secretary. "Additional research must be conducted to enhance antiviral treatment for this serious disease."

References

1 World Health Organization. Hepatitis D. Available from: http://www.who.int/csr/disease/hepatitis/whocdscsrncs20011/en/index1.html. Last accessed: March 2016.

2 World Health Organization. What is hepatitis? Available from: http://www.who.int/features/qa/76/en/. Last accessed: March 2016.

3 EASL. EASL Clinical practice guidelines. Available from: http://www.easl.eu/research/our-contributions/clinical-practice-guidelines/detail/management-of-chronic-hepatitis-b-virus-infection/report/4. Last accessed: April 2016.