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Wranke A, Hardtke S, Heidrich B, Dalekos G, Yalçin K, Tabak F, Gürel S, Çakaloğlu Y, Akarca US, Lammert F, Häussinger D, Müller T, Wöbse M, Manns MP, Idilman R, Cornberg M, Wedemeyer H, Yurdaydin C. Ten-year follow-up of a randomized controlled clinical trial in chronic hepatitis delta. J Viral Hepat 2020; 27:1359-1368. [PMID: 32707605 DOI: 10.1111/jvh.13366] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022]
Abstract
Hepatitis delta virus (HDV) infection causes the most severe form of viral hepatitis. PEG-interferon alpha-2a (PEG-IFNα-2a) is the only effective treatment but its long-term clinical impact is unclear. The aim of this study was to investigate the long-term outcome after 48 weeks of pegylated interferon alpha-2a therapy. We performed a retrospective follow-up study of the Hep-Net-International-Delta-Hepatitis-Intervention-Study 1 (HIDIT-I trial). Patients had received 48 weeks of treatment with either PEG-IFNα-2a plus adefovir dipivoxil (ADV) (Group I), PEG-IFNα-2a alone (Group II) or adefovir dipivoxil alone (Group III). Liver-related complications were defined as liver-related death, liver transplantation, liver cancer and hepatic decompensation defined as development of Child-Pugh scores B or C or an increase in Model for End-stage Liver Disease (MELD) scores of five or more points in relation to baseline values. Patients were considered for further analysis when they were retreated with PEG-IFNα-2a. Follow-up data (at least 1 visit beyond post-treatment week 24) were available for 60 patients [Group I, (n = 19), Group II (n = 20), Group III (n = 21)]. Mean time of follow-up was 8.9 (1.6 - 13.4) years. 19 patients were retreated with IFN-based therapy: 42% (n = 8) in PEG-IFNα-2a arms and 58% (n = 11) in the adefovir only arm. Clinical complications on long-term follow-up occurred in 17 patients and were associated with nonresponse to therapy and baseline cirrhosis. The annual event-free survival rate in patients with cirrhosis vs noncirrhotic patients at year 5 and 10 was 70% vs 91% and 35% vs 76%. Long-term follow-up of a large randomized clinical trial suggests that off-treatment HDV RNA response to PEG-IFNα-2a treatment leads to improved clinical long-term outcome.
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Affiliation(s)
- Anika Wranke
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Svenja Hardtke
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site HepNet Study-House, Hannover, Germany
| | - Benjamin Heidrich
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site HepNet Study-House, Hannover, Germany
| | - George Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, University Hospital of Larissa, Larissa, Greece
| | - Kendal Yalçin
- Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Selim Gürel
- Uludağ University Medical School, Bursa, Turkey
| | | | | | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Düsseldorf, Germany
| | | | - Michael Wöbse
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site HepNet Study-House, Hannover, Germany
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site HepNet Study-House, Hannover, Germany
| | - Heiner Wedemeyer
- German Center for Infection Research (DZIF), Partner Site HepNet Study-House, Hannover, Germany.,Department of Gastroenterology and Hepatology, Essen University Hospital, Medical Faculty of the University Duisburg-Essen, Essen, Germany
| | - Cihan Yurdaydin
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.,Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
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Wranke A, Hardtke S, Borzacov LMP, Parana R, Lobato C, Hamid S, Ceausu E, Dalekos GN, Rizzetto M, Turcanu A, Niro G, Ingiliz P, Muche M, Buti M, Ferenci P, Vanwolleghem T, Motoc A, Serrano BC, Wöbse M, Abbas Z, Yurdaydin C, Manns MP, Wedemeyer H. Diversity of clinical presentation and virological characteristics of hepatitis delta: The hepatitis Delta International network (HDIN). Z Gastroenterol 2016. [DOI: 10.1055/s-0036-1597511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Wranke
- Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
| | - S Hardtke
- HepNet Study-House, German Centre for Infection Research (DZIF), Hannover, Germany
| | - LMP Borzacov
- Federal University of Rondônia, Research Center for Tropical Medicine of Rondônia – CEPEM/SESAU, Rondônia, Brasil
| | - R Parana
- Federal University of Bahia, Hepatology Center of the University Hospital Professor Edgar Santos, Bahia, Brasil
| | - C Lobato
- Hospital das Clínicas do Acre, Rio Branco, Acre, Brazil
| | - S Hamid
- Aga Khan University, Karachi, Pakistan
| | - E Ceausu
- Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Infectious Diseases, Bucharest, Romania
| | - GN Dalekos
- Medical School, University of Thessaly, Department of Medicine and Research Laboratory of Internal Medicine, Larissa, Greece
| | - M Rizzetto
- University of Torino, Department of Internal Medicine – Gastroenterology, Torino, Italy
| | - A Turcanu
- State University of Medicine and Pharmacy 'Nicolae Testemitanu', Department of Gastroenterology, Chisinau, Moldovia
| | - G Niro
- Ospedale Generale Regionale “Casa Sollievo della Sofferenza, Divisione di Gastroenterologia, San Giovanni Rotondo, Italy
| | - P Ingiliz
- Center for Infectiology Berlin (CIB), Berlin, Germany
| | - M Muche
- Charite, Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany
| | - M Buti
- Valle d'Hebron (Ciberehd) University Hospital, Liver Unit, Barcelona, Spain
| | - P Ferenci
- Medical University of Vienna, Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
| | - T Vanwolleghem
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | - A Motoc
- Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Infectious Diseases, Bucharest, Romania
| | - BC Serrano
- Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
| | - M Wöbse
- Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
| | - Z Abbas
- Sindh Institute of Urology and Transplantation, Department of Hepatogastroenterology, Karachi, Pakistan
| | - C Yurdaydin
- Ankara University, Medical Faculty, Ankara, Turkey
| | - MP Manns
- Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
| | - H Wedemeyer
- Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
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