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The role of HBeAg seroconversion in acute exacerbation of liver disease with termination of hepatitis B and D virus infection in a chronic hepatitis D patient during alpha-interferon therapy.

Abstract
We report a severe flare-up in a chronic hepatitis patient due to dual infection with hepatitis B and D viruses during alpha-interferon therapy. Pre-treatment, the patient had detectable levels of both viruses. After 9 months of therapy, an alanine aminotransferase flare with acute hepatic decompensation was detected. Alpha-interferon was discontinued and lamivudine (100 mg once daily) was started, after which the patient reversed slowly. Hepatitis B early antigen (HBeAg) seroconversion with hepatitis B virus-DNA clearance was observed 1 month after the flare; 15 months later, the patient had persistently normal alanine aminotransferase levels with negative results for both serum hepatitis B virus-DNA and hepatitis D virus-RNA. In conclusion, liver disease may be exacerbated during interferon therapy in patients with chronic hepatitis D who are also positive for hepatitis B surface antigen (HBsAg) and HBeAg. Therefore, extra care in monitoring should be considered and strict follow-up is recommended, since clearance of hepatitis D may occur after HBeAg seroconversion in coinfected patients. Lamivudine may be administered early in hepatitis D-RNA/HBsAg-positive patients at high risk of liver failure once a severe flare-up occurs during interferon therapy.
AuthorsKendal Yalcin, Halil Degertekin, Cihan Yurdaydin, Mithat Bozdayi, Hakan Bozkaya
JournalEuropean journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 15 Issue 7 Pg. 819-23 (Jul 2003) ISSN: 0954-691X [Print] England
PMID12811314 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antiviral Agents
  • Hepatitis B e Antigens
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
Topics
  • Acute Disease
  • Antiviral Agents (adverse effects)
  • Follow-Up Studies
  • Hepatitis B e Antigens (blood)
  • Hepatitis B, Chronic (complications, immunology)
  • Hepatitis D, Chronic (complications, drug therapy, immunology)
  • Humans
  • Interferon alpha-2
  • Interferon-alpha (adverse effects)
  • Male
  • Middle Aged
  • Recombinant Proteins

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