'Double-hit' pegylated interferon-alpha successfully treats Hepatitis B and Hepatitis D co-infection. Issue 10 (23rd October 2020)

• Record Type: Journal Article
• Authors: Bhuva, Meha; Moore, Marie; Sen, Sambit
• Is Part Of: Oxford medical case reports. Volume 2020:Issue 10(2020)
• Publication Date: 2020-10-23
• Subjects: Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1093/omcr/omaa084
• Languages: English
• ISSNs: 2053-8855

Abstract

Abstract: Hepatitis delta (HDV) infection is either acquired simultaneously with, or as a superinfection to, existing Hepatitis B (HBV). It leads to a serious form of chronic viral hepatitis and accelerated liver-related morbidity and mortality including hepatocellular carcinoma. Current treatment regimes propose Pegylated interferon-alpha for 48 weeks however sustained virological response (SVR) rates remain low. We report a patient who initially responded to Pegylated interferon treatment for HBV-HDV co-infection. Although initial improvement in viraemia from both virsues was seen, SVR was not achieved with ongoing progression of liver injury biochemically. However, the summative effect of a second course of Pegylated interferon 2 years later led to HDV cure (SVR 12 months post-treatment), very low level HBV carrier status (with persistently undetectable viral load) and ongoing biochemical normalization. This case illustrates a successful treatment strategy for persistent HBV-HDV co-infection where proposed treatment regimes elicit an initial response but SVR is not achieved.