Entecavir treatment of chronic hepatitis D.

Abstract

BACKGROUND:

Hepatitis D virus (HDV) requires hepatitis B surface antigen (HBsAg) to propagate infection and cause disease. Entecavir is a nucleoside analog with potent antiviral efficacy, and in the woodchuck animal model it also decreased hepatitis B virus (HBV) cccDNA and woodchuck surface antigen. The aim of this study was to investigate the efficacy of entecavir in chronic hepatitis D (CHD).

METHODS:

This single-center study was conducted in patients with compensated liver disease. All patients had to have detectable hepatitis HDV RNA and elevated levels of alanine aminotransferase (ALT). Entecavir was given at a dosage of 1 mg/d for 1 year. The primary end point was achievement of undetectable HDV RNA at the end of treatment.

RESULTS:

Thirteen consecutive patients were assessed. All patients had detectable HDV RNA, and 8 had detectable HBV DNA at baseline. At the end of treatment, HBV DNA became undetectable in all patients (P = .001). No significant decline in HDV RNA, ALT, or quantitative HBsAg levels was observed. The primary end point of undetectable HDV RNA at the end of treatment was achieved in 3 patients who had significantly lower baseline HDV RNA levels than nonresponders (2.99 log(10) copies/mL ± .70 vs 4.68 ± .97; P = .0185). In all 3 patients, ALT levels were also normal at the end of treatment.

CONCLUSIONS:

One year of entecavir treatment is ineffective in CHD. Any generalized beneficial effect of nucleoside/nucleotide analog treatment may necessitate prolonged treatment. Patients with CHD with HBV dominance, which is likely to occur in the later phases of CHD, may be a reasonable patient cohort in which to target nucleoside/nucleotide analog therapy.

• Authors: Gökhan Kabaçam, F Oguz Onder, Mustafa Yakut, Gülseren Seven, Senem C Karatayli, Ersin Karatayli, Berna Savas, Ramazan Idilman, A Mithat Bozdayi, Cihan Yurdaydin
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 55 Issue 5 Pg. 645-50 (Sep 2012) ISSN: 1537-6591 [Electronic] United States
• PMID: 22573857 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• RNA, Viral
• entecavir
• Guanine
• Alanine Transaminase

Topics

• Adult
• Alanine Transaminase (metabolism)
• Antiviral Agents (therapeutic use)
• Female
• Guanine (analogs & derivatives, therapeutic use)
• Hepatitis B (blood, drug therapy, virology)
• Hepatitis B virus (genetics, isolation & purification)
• Hepatitis D, Chronic (blood, drug therapy, virology)
• Hepatitis Delta Virus (genetics, isolation & purification)
• Humans
• Male
• Middle Aged
• RNA, Viral (blood)
• Retrospective Studies
• Statistics, Nonparametric