Treatment of Chronic Delta Hepatitis: A Nine-Year Retrospective Analysis

BACKGROUND Chronic delta hepatitis is the most severe form of viral hepatitis, for which interferon administration is the only available treatment. However, the efficacy of interferon treatment is affected by the dose and duration of treatment, and relapse rates are high. OBJECTIVES In this study, we sought to evaluate the efficacy of treatment with pegylated interferon and observe the relapse rates of delta hepatitis after treatment. PATIENTS AND METHODS Forty-six patients with chronic delta hepatitis were retrospectively studied between January 2002 and December 2010. Patients were evaluated for biochemical, virological, and histological responses. They were then followed-up for at least 1 year after discontinuation of the treatment. RESULTS All the 46 patients in the study received PEG-IFN therapy. Of the 46 patients,25 were treated with PEG-IFN for 1 year and 21 were treated for 2 years. Sixteen patients(34.7%) showed a biochemical response, 27 (58.6%) showed a virological response, and 39 (84.7%) showed a histological response. Sustained virological and biochemical responseswere achieved in 41% and 47.8% of the patients, respectively. Sixteen (84.2%) patients of the 19 with high levels of hepatitis delta virus RNA (HDV RNA) (HDV RNAlevel > 1 × 105) and 10 (71.4%) of the 14 patients with high titers of hepatitis B surface antigen(HbsAg) (HbsAg > 102 IU/mL) at the beginning of the treatment showed relapse after treatment. CONCLUSIONS We found no significant differences between 1-year and 2-year treatments.However, the relapse rate was lower in the 2-year treatment group. Higher HDV RNA and HbsAg levels before treatment were associated with higher relapse rates. Younger age was a significant factor in predicting response.