In:
Alimentary Pharmacology & Therapeutics, Wiley, Vol. 54, No. 4 ( 2021-08), p. 462-469
Abstract:
Spontaneous HDV‐RNA fluctuations, assessed by nonstandardised in‐house assays, have been reported during the course of chronic hepatitis delta (CHD). Aims To evaluate changes in serum HDV‐RNA concentrations in untreated CHD patients and correlate these changes with other HBV markers. Methods A total of 323 consecutive serum samples from 56 CHD patients (detectable HDV‐RNA) followed for 〉 3 years were retested for HDV‐RNA levels by a sensitive technique using the first WHO international HDV‐RNA standard. Quantitative HBsAg, HBV‐DNA, and HBV‐RNA were also determined. Results Most participants were male, middle‐aged, white European, and HBeAg‐negative (82%). Almost half had liver cirrhosis and 64% were receiving nucleos(t)ide analogues. At inclusion, median‐HDV‐RNA was 5.3 (4.2‐6.5) log 10 IU/mL, HBsAg 4.0 (3.5‐4.3) log 10 IU/mL, and HBV‐DNA 1.6 (1.0‐2.6) log 10 IU/mL; ALT values were normal in 13 (23%). During a mean follow‐up of 5.6 (3‐16) years, 14 (25%) showed ≥2log 10 HDV‐RNA decline, including 11 (20%) who spontaneously achieved undetectable HDV‐RNA. Four patients (7%) lost HBsAg, with undetectable HDV‐RNA. The remaining 42 (75%) had persistently detectable HDV‐RNA. During follow‐up, patients with a ≥2log 10 HDV‐RNA decline showed a greater HBsAg drop (−0.7 ± 1.1 vs −0.09 ± 0.9 log IU/mL; P = 0.039) than those with a 〈 2 log 10 HDV‐RNA decline. Overall, ALT and HBV‐DNA levels decreased over time. There were no differences in clinical outcomes between groups. Conclusions One‐quarter of untreated CHD patients showed a ≥2log 10 decline in HDV‐RNA and 20% reached HDV‐RNA undetectability during a mean follow‐up of 5.6 years. The decline was associated with ALT decrease. These findings have implications for designing new therapies for CHD.
Type of Medium:
Online Resource
ISSN:
0269-2813
,
1365-2036
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2003094-0
SSG:
15,3
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