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HBsAg kinetics in chronic hepatitis D during interferon therapy: on‐treatment prediction of response
Author(s) -
Niro G. A.,
Smedile A.,
Fontana R.,
Olivero A.,
Ciancio A.,
Valvano M. R.,
Pittaluga F.,
Coppola N.,
Wedemeyer H.,
Zachou K.,
Marrone A.,
Fasano M.,
Lotti G.,
Andreone P.,
Iacobellis A.,
Andriulli A.,
Rizzetto M.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13734
Subject(s) - hbsag , medicine , gastroenterology , hepatitis d virus , clearance , interferon , hepatitis d , pegylated interferon , immunology , virology , chronic hepatitis , hepatitis b virus , virus , urology , ribavirin
Summary Background Therapy of chronic hepatitis D with Interferon is successful when testing for HDV‐RNA turns negative. This end‐point is disputed. Aim To assess the role of serum hepatitis B surface antigen ( HB sAg) in the clearance of HDV ‐ RNA in pegylated interferon (Peg‐ IFN )‐treated chronic hepatitis D ( CHD ). Methods Sixty‐two patients with CHD , treated with Peg‐ IFN , were considered. The patients belonged to three groups: 14 patients cleared the HB sAg and HDV ‐ RNA (responders, R), 12 cleared the HDV ‐ RNA remaining positive for HB sAg (partial responders, PR ) and 36 cleared neither the HB sAg nor the HDV ‐ RNA (nonresponders, NR ). Results In responders, at baseline the median value (mv) of HB sAg and HDV ‐ RNA was 1187 and 188 663 IU /mL. By month 6 of therapy, HB sAg declined to less than 1000 IU /mL and HDV ‐ RNA was undetectable in 12 patients. In NR, the pre‐therapy median value of HB sAg 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 HB sAg 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. HB sAg <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 HB sAg associated with 1.610 log reduction of HDV ‐ RNA from baseline to month 6 predicted the clearance of this marker. Conclusions A reduction of serum HB sAg is mandatory for the definitive clearance of the HDV ‐ RNA . Quantitative HB sAg may predict the long‐term response to Peg‐ IFN therapy and provide a guide to prolong or stop treatment.