HEPATITIS D TREATMENT WITH PEGYLATED INTERFERON: OUTCOME ASKING FOR AN URGENT ALTERNATIVE

Abstract

ABSTRACT:
BACKGROUND: Viral hepatitis is a global health issue mainly prevalent in countries in Asia
and Africa where hepatitis B (HBV) is endemic. OBJECTIVE: To determine the efficacy of
pegylated interferon alpha in Hepatitis D patients. STUDY DESIGN: Quasi-experimental study.
PLACE AND DURATION OF STUDY: Al-Tibri Medical College Hospital Karachi and OPD
Saylani Welfare Trust Karachi from August 2021 to December 2022. METHODOLOGY:
Adult patients of either gender and all ages infected with HDV as evidenced by anti-HDV
antibodies positive along with detectable levels of HDV RNA in the serum by polymerase chain
reaction (PCR) were included in the study. A written informed consent was taken from all
patients, and pegylated interferon alpha (180 mcg subcutaneously weekly) was started for at 48
weeks. HDV RNA by quantitative PCR has been done before and after treatment. All patients
were followed up in the outpatient clinics every month for clinical, hematological, and
biochemical assessments for any adverse effects of treatment. At the end of treatment, the overall
response to therapy as depicted by non-detectable HDV RNA by PCR was analyzed by applying
the chi-square test and using SPSS 23.0 statistical software. Significance was kept at a p-value of
less than 0.05. RESULTS: Ninety-seven patients were assessed for eligibility. After excluding
31 patients, a total of 66 patients were enrolled for a 48-week course of pegylated interferon
therapy at a dose of 180 mg/week. Out of the 42 patients, 16 (38.1%) responded to the treatment,
compared to 26 (61.9%) no responders. No significant difference was seen in association with
gender, age and viral load of patients with responders and non-responder’s groups of treatment.
CONCLUSION: The study found that pegylated interferon treatment of hepatitis D patients was
challenging, with only 38% of patients achieving sustained suppression of hepatitis D virus
replication after 48 weeks of treatment