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Anti-HDV immunoglobulin M testing in hepatitis delta revisited: correlations with disease activity and response to pegylated interferon-α2a treatment.

AbstractBACKGROUND:
The role of anti-HDV immunoglobulin M (IgM) testing in patients receiving pegylated interferontherapy for hepatitis delta is unknown. We performed anti-HDV IgM testing in a well defined cohort of HDV-infected patients who were treated with pegylated interferon-α2a plus adefovir, or either drug alone.
METHODS:
Sera from 33 HDV-RNA-positive patients from the international HIDIT-1 trial were available for anti-HDV IgM testing (ETI-DELTA-IGMK-2 assay, DiaSorin, Saluggia, Italy) before therapy, at treatment weeks 24 and 48, and at 24 weeks after the end of treatment.
RESULTS:
Anti-HDV IgM tested positive in 31 out of the 33 patients (94%) prior to treatment. HDV IgM levels correlated with histological inflammatory activity (r=0.51, P<0.01) and were higher in patients with alanine aminotransferase and γ-glutamyl transpeptidase levels above the median (P<0.05). Quantitative anti-HDV IgM values declined in patients responding to antiviral therapy, however anti-HDV IgM remained positive after treatment in the majority of virological responders.
CONCLUSIONS:
We suggest that anti-HDV IgM testing might give additional useful information to determine disease activity in hepatitis delta and to predict treatment response to antiviral therapy with type I interferons. However, determination of anti-HDV IgM can not substitute HDV RNA testing, which remains the primary virological marker for response to therapy.
AuthorsIngmar Mederacke, Cihan Yurdaydin, George N Dalekos, Birgit Bremer, Andreas Erhardt, Yilmaz Cakaloglu, Kendal Yalcin, Selim Gurel, Stefan Zeuzem, Kalliopi Zachou, Hakan Bozkaya, Hans Peter Dienes, Michael P Manns, Heiner Wedemeyer, Hep-Net/International Delta Hepatitis Study Group
JournalAntiviral therapy (Antivir Ther) Vol. 17 Issue 2 Pg. 305-12 ( 2012) ISSN: 2040-2058 [Electronic] England
PMID22293066 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiviral Agents
  • Hepatitis Antibodies
  • Immunoglobulin M
  • Interferon-alpha
  • Organophosphonates
  • RNA, Viral
  • Recombinant Proteins
  • Polyethylene Glycols
  • adefovir
  • gamma-Glutamyltransferase
  • Alanine Transaminase
  • Adenine
  • peginterferon alfa-2a
Topics
  • Adenine (analogs & derivatives, therapeutic use)
  • Adult
  • Alanine Transaminase (blood)
  • Antiviral Agents (therapeutic use)
  • Female
  • Hepatitis Antibodies (blood)
  • Hepatitis D (drug therapy, immunology)
  • Hepatitis Delta Virus (genetics, immunology)
  • Humans
  • Immunoglobulin M (blood, immunology)
  • Interferon-alpha (therapeutic use)
  • Male
  • Middle Aged
  • Organophosphonates (therapeutic use)
  • Polyethylene Glycols (therapeutic use)
  • RNA, Viral (blood)
  • Recombinant Proteins (therapeutic use)
  • Young Adult
  • gamma-Glutamyltransferase (blood)

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