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Meta-analysis: antiviral treatment for hepatitis D
C Triantos1, M Kalafateli, V Nikolopoulou
1Department of Gastroenterology, University Hospital of Patras, Stamatopoulou 4, Patras, Greece. chtriantos@hotmail.com
Hepatitis D (HDV) treatment remains challenging. Pegylated interferon alfa (PEG-IFNa) shows superiority over other medications for viral clearance and sustained response, suggesting its potential in future combination therapies.
Area of Science:
- Hepatology
- Virology
- Clinical Pharmacology
Background:
- Hepatitis D virus (HDV) infection lacks effective therapeutic options.
- Current treatments for HDV are unsatisfactory, necessitating further research.
Purpose of the Study:
- To conduct a meta-analysis evaluating the efficacy of various treatments for Hepatitis D.
- To compare different interferon-based therapies for HDV infection.
Main Methods:
- Systematic literature search of Medline, Scopus, Cochrane Library, and ISI Web of Knowledge.
- Inclusion of randomized clinical trials (RCTs) comparing interferon alfa (IFNa), pegylated interferon alfa (PEG-IFNa), and combination therapies.
- Endpoints included biochemical and virological response at end of treatment (EOT) and end of follow-up (EOFUP), histological improvement, and HDAg clearance.
Main Results:
- Interferon alfa (IFNa) demonstrated efficacy for end-of-treatment (EOT) biochemical and virological response but not sustained response.
- High-dose IFNa was superior to low-dose IFNa for EOT outcomes.
- Pegylated interferon alfa (PEG-IFNa) showed significant advantages in EOT virological response, EOFUP virological response, and necroinflammatory activity improvement compared to other medications.
Conclusions:
- Long-term suppression of HDV RNA by IFNa is not consistently maintained.
- Adding lamivudine to IFNa did not show significant benefits.
- PEG-IFNa is a more effective treatment option for HDV infection, outperforming other medications in achieving virological response and sustained viral suppression.
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