scholarly journals An update on the management of chronic hepatitis D

2019 ◽  
Vol 7 (6) ◽  
pp. 396-402 ◽  
Author(s):  
Pir Ahmad Shah ◽  
Saad Choudhry ◽  
Karen J Campoverde Reyes ◽  
Daryl T Y Lau
Keyword(s):  
Chronic Hepatitis ◽  
Antiviral Agents ◽  
Therapeutic Agents ◽  
Clinical Development ◽  
Severe Liver ◽  
Hepatitis D ◽  
Diagnostic Assays ◽  
Enhanced Sensitivity ◽  
At Risk Populations ◽  
Hdv Infection

Abstract Hepatitis D virus (HDV) infection is associated with severe liver-related morbidity and mortality. The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas. Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations. Until recently, interferon has been the only treatment for hepatitis D. Its efficacy is, however, limited and it is associated with significant side effects. A number of novel antiviral agents that target various stages of the HDV life cycle show promising results. They are currently in different phases of clinical development. This review focuses on the changing epidemiology, novel therapeutic agents, and updated management of chronic hepatitis delta.

Chronic Hepatitis D Virus (HDV) Infection in Hepatitis B Virus Carrier Chimpanzees Experimentally Superinfected with HDV

1988 ◽  
Vol 158 (1) ◽  
pp. 151-159 ◽  
Author(s):  
F. Negro ◽  
K. F. Bergmann ◽  
B. M. Baroudy ◽  
W. C. Satterfield ◽  
H. Popper ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hepatitis D ◽  
Hepatitis D Virus ◽  
B Virus ◽  
Hepatitis B Virus Carrier ◽  
Hdv Infection ◽  
Virus Carrier

scholarly journals Hepatitis D virus antibodies and liver function profile among patients with chronic hepatitis B infection in Abuja, Nigeria

2021 ◽  
Vol 15 (01) ◽  
pp. 141-146
Author(s):  
Lukman O Abdulkareem ◽  
Dennis A Ndububa ◽  
Augustine O Uhunmwangho ◽  
Thahir Yunusa
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Liver Function ◽  
Chronic Hepatitis B ◽  
Prevalence Rate ◽  
Cross Sectional ◽  
Hepatitis D ◽  
Hepatitis D Virus ◽  
The Mean ◽  
Hdv Infection

Introduction: Hepatitis D virus (HDV) is a satellite virus of hepatitis B virus (HBV). An estimated 5% of HBV infected individuals worldwide have HDV infection. There is paucity of studies in Nigeria on the burden of HDV infection. This study aimed at determining the prevalence rate of HDV antibodies among individuals with chronic hepatitis B (CHB) infection and comparing the liver function test (LFT) and disease severity among the anti-HDV positive (anti-HDV+) and anti-HDV negative (anti-HDV-) individuals. Methodology: A cross-sectional study of 180 CHB infected individuals who were clinically evaluated and tested for HDV antibodies using the Enzyme-linked Immunoassay method. Their LFT profile and Child-Turcotte-Pugh (CTP) were also assessed. Data were analyzed using the SPSS version 17. Results: Their mean age was 35.2 ± 10.4 years. There were 150 (83.3%) and 30 (16.7%) individuals with uncomplicated and complicated CHB infection respectively. Thirty-four (18.9%) of the participants were anti-HDV+. The mean serum ALT, AST, albumin and INR of the anti-HDV+ subjects were 16.5 ± 13.8 IU/L, 26.3 ± 32.6 IU/L, 38.9 ± 7.6 g/L, and 1.2 ± 0.2 respectively. The mean values for the same parameters of the anti-HDV- subjects were 10.8 ± 9.5 IU/L, 13.4 ± 11.2 IU/L, 41.4 ± 6.0 g/L and 1.1 ± 0.2 respectively (p < 0.05). The mean CTP scores in the anti-HDV+ and anti-HDV- subjects were 6.1 ± 2.1 and 5.5 ± 1.2 respectively (p= 0.03). Conclusions: Anti-HDV sero-prevalence rate was 18.9% and anti-HDV+ CHB patients had worse LFT results compared to those who were anti-HDV–.

scholarly journals Prevalence of hepatitis D virus among HBsAg-positive individuals,2015-2016: Azar cohort study

2020 ◽  
Vol 10 (1) ◽  
pp. 38-42
Author(s):  
Ali Asghar Pouri ◽  
Morteza Ghojazadeh ◽  
Babak Baiaz ◽  
Fatemeh Soghra Hamzavi ◽  
Behrouz Pourasghari ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hepatitis D ◽  
Hepatitis D Virus ◽  
B Virus ◽  
Hdv Infection

Background: Hepatitis D virus (HDV) is a defective RNA pathogen that requires the presence of the hepatitis B virus (HBV) for infection. Middle East countries are endemic areas for HDV infection. So, it is important to estimate the prevalence of HDV in these countries. This study aimed to estimate the prevalence of HDV in HBsAg positive patients participated in Azar cohort study, North-west of Iran. Methods: In this cross-sectional study, out of 4949 participants of the Azar cohort study, 51HBsAg positive patients were selected. Five participants did not consent to HDV testing. The presence of anti-HDV IgG was checked in 46 patients (13 chronic hepatitis B and 33 inactive chronic hepatitis B) using enzyme-linked immunosorbent assay (ELISA) kit. The serum level of liver enzymes was measured and a questionnaire about risk factors was completed.Results: In this study, the mean age of HBsAg positive patients was 50.06 (SD 9.14) years and41.3% were female. Only one out of 46 patients was positive for HDV infection. Thus, the prevalence of HDV infection among hepatitis B virus surface antigen (HBsAg) positive patients was 2.17% (95% CI: 0.1-11.5). The positive anti-HDV patient was in the inactive chronic hepatitis B state and she had a history of hospitalization and dental procedures. Conclusion: The results showed that the prevalence of HDV infection in HBsAg positive patients was 2.1% that was lower than the reported prevalence in many other regions of Iran. Health policymakers and healthcare providers should design coherent and orderly epidemiological studies for planning and monitoring HDV infection.

scholarly journals Chronic delta hepatitis: from discovery to new treatments

2021 ◽  
Vol 2 (2) ◽  
pp. 19-26
Author(s):  
Adela TURCANU ◽  
Suhaib TAHIR WANI
Keyword(s):  
Chronic Hepatitis ◽  
Mediterranean Region ◽  
Rna Virus ◽  
European Countries ◽  
Human Pathogens ◽  
Genotype 3 ◽  
Hepatitis Delta ◽  
Hepatitis D ◽  
The Mediterranean ◽  
Hdv Infection

Introduction. Hepatitis delta virus (HDV) is a small, defective RNA virus that is related more to plant viroids than to other human pathogens. Material and methods. Nearly 50 research articles from various sources were reviewed and a comprehensive analysis was done regarding various parameters concerning HDV. Articles published over a period of 30 years were selected based on their experimental and statistical relevance to HDV. This review gives a brief insight into epidemiology, genetics, clinical evolution and treatment of chronic hepatitis delta. Results. Chronic hepatitis delta remains a major cause of morbidity in Eastern European countries and the Mediterranean region. At the same time, there is a resurgence of HBV and HDV infection in young people (under the age of 50) in Western Europe, as a consequence of the intra-familial and sexual mode of acquisition among immigrants from Eastern Europe, the Mediterranean region and from countries of the former Soviet Union, Africa high burdened regions of Asia and South America. Prevalence among IVDU was found to be higher especially in western european countries and other regions of low HDV prevalence. Chronic delta viral hepatitis is a dynamic, progressive process. A direct cytopathic pattern of liver tissue damage was also observed, especially in the presence of HDV genotype 3. Chronic hepatitis D is reported to progress to cirrhosis and hepatocellular cancer, and this trend is greater the higher the level of HDV viremia at the time of presentation. Conclusions. Flaws in screening and on-time diagnosis still remain due to the insufficient research and data available. While still not classified as a carcinogen by IARC, our review ends up in support of the notion that HDV infection increases the chances and fastens the pathogenic processes leading to HCC.

scholarly journals Effectiveness and safety of orally administered silymarin (milk thistle) for pegylated interferon unresponsive chronic delta hepatitis patients

2021 ◽  
Vol 8 (7) ◽  
pp. 428-431
Author(s):  
Mesut Aydin ◽  
Erhan Ergin ◽  
Elif Tugba Tuncel ◽  
Yaren Dirik ◽  
Suat Ozluk ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Treatment Success ◽  
Sustained Viral Response ◽  
Pegylated Interferon ◽  
Decompensated Cirrhosis ◽  
Milk Thistle ◽  
Hepatitis C Infection ◽  
Hepatitis D ◽  
End Of Treatment ◽  
Hdv Infection

Objective: Silymarin is a natural extract from milk thistle (Silybum marianum), a natural herb that contains flavonoids. Silymarin also has anti-inflammatory properties and lipid peroxidation effects on human hepatocytes. It has also been used for the treatment of acute alpha-amanitin poisoning and chronic hepatitis C infection.  Chronic Hepatitis D virus (HDV) infection is a severe health problem leading to fibrosis and hepatocellular carcinoma. Patients with chronic HDV infection can be treated with Peg-IFN with lower treatment success.  Most patients with chronic HDV are unable or unwilling to use interferon (IFN)-based treatment due to liver cirrhosis. Our objective was to establish the long-term clinical outcomes with silymarin for interferon-experienced chronic HDV patients. Materials and Methods: We studied ten patients from one centre with interferon who experienced chronic HDV, of which 8 had cirrhosis, and 2 had chronic hepatitis who received HDV treatment with silymarin 600 mg/day after a median period of 12 months. Information collected included demographic, clinical, virologic, and outcomes data. MELD and Child-Pugh (CP) scores were also obtained. Friedman test was used to evaluate the laboratory parameters during the study period. Results: 10 chronic HDV patients (median age 54 yrs, six female, all of them previous null responders to Peg-IFN  with mildly decompensated cirrhosis [CP 7 (range 6-11), MELD 11 (range 6-20] were followed for 12 months from the start of silymarin 600 mg/day. There was no decompensation of both MELD and CP scores among patients at the end of therapy. In addition, no patients stopped silymarin treatment early due to side effects. At the end of treatment, there was no significant change in prothrombin time (p= 0.949), AST (p=0.662) and AFP (p=0.983) levels and platelets counts (p=0.988) compared to the pre-treatment period (all p>0.005). Finally, HDV-RNA suppression was seen in all patients at the end of treatment (p=0.009). Conclusions: In the light of the presented data, silymarin seems to be effective in treating chronic HDV infection. Further research is needed for validation. The study is ongoing with a collection of data on sustained viral response.

scholarly journals Recent advances in managing hepatitis D

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1596 ◽  
Author(s):  
Cihan Yurdaydin
Keyword(s):  
Chronic Hepatitis ◽  
Life Cycle ◽  
Viral Hepatitis ◽  
Management Strategies ◽  
Chronic Viral Hepatitis ◽  
Severe Form ◽  
Background Information ◽  
Hepatitis D ◽  
Recent Advances ◽  
Hdv Infection

Hepatitis D virus (HDV) infection leads to the most severe form of chronic viral hepatitis and requires the attention of a liver specialist. In this review, I will recapitulate recent advances in the management of HDV, present background information on HDV infection as well as current chronic hepatitis D treatment, briefly examine the HDV life cycle and discuss new management strategies.

scholarly journals Positive Selection of Hepatitis Delta Antigen in Chronic Hepatitis D Patients

2007 ◽  
Vol 81 (9) ◽  
pp. 4438-4444 ◽  
Author(s):  
Shen-Yung Wang ◽  
Jaw-Ching Wu ◽  
Tzen-Yuh Chiang ◽  
Yi-Hsiang Huang ◽  
Chien-Wei Su ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Positive Selection ◽  
Cytotoxic T Lymphocyte ◽  
Hepatitis Delta ◽  
Hepatitis D ◽  
Serum Aminotransferase ◽  
Novel Treatments ◽  
Delta Antigen ◽  
Hepatitis Delta Antigen ◽  
Hdv Infection

ABSTRACT Liver disease may become ameliorated in some patients with chronic hepatitis D virus (HDV) infection. We present here a study based on longitudinal sampling to investigate the viral dynamics in chronic HDV infection. We examined the HDV variants from different time points, especially those before and after the elevation of serum aminotransferase levels. The datasets from each patient were tested for positive selection by using maximum-likelihood methods with heterogeneous selective pressures along the nucleotide sequence. An average of 4.9%, ranging from 3.1 to 6.8%, of the entire delta antigen sites was regulated by a diversifying selection. Most of the positively selected sites were associated with immunogenic domains. Likelihood ratio tests revealed a significant fitness of positive selection over neutrality of the hepatitis delta antigen gene in all patients. We further adapted a neural network method to predict potential cytotoxic T ligand epitopes. Among the HLA-A*0201 cytotoxic T ligand epitopes, three consistent epitopes across all three genotypes were identified: amino acids (aa) 43 to 51, 50 to 58, and 114 to 122. Three patients (60%) had sites evolving under positive selection in the epitope from aa 43 to 51, and four patients (80%) had sites evolving under positive selection in the epitope from aa 114 to 122. The discovery of immunogenic epitopes, especially cytotoxic-T-lymphocyte ligands, associated with chronic HDV infection may be crucial for further development of novel treatments or designs in vaccine for HDV superinfection.

scholarly journals Role of hepatitis D virus infection in development of hepatocellular carcinoma among chronic hepatitis B patients treated with nucleotide/nucleoside analogues

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tyng-Yuan Jang ◽  
Yu-Ju Wei ◽  
Ta-Wei Liu ◽  
Ming-Lun Yeh ◽  
Shu-Fen Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Nucleoside Analogues ◽  
Hepatitis D ◽  
Hepatitis D Virus ◽  
Cirrhotic Patients ◽  
Hdv Infection

AbstractHepatitis D virus (HDV) infection increases the risk of hepatocellular carcinoma (HCC) in the natural course of chronic hepatitis B (CHB) patients. Its role in patients treated with nucleotide/nucleoside analogues (NAs) is unclear. We aimed to study the role of hepatitis D in the development of HCC in CHB patients treated with NAs. Altogether, 1349 CHB patients treated with NAs were tested for anti-HDV antibody and RNA. The incidence and risk factors of HCC development were analyzed. Rates of anti-HDV and HDV RNA positivity were 2.3% and 1.0%, respectively. The annual incidence of HCC was 1.4 per 100 person-years after a follow-up period of over 5409.5 person-years. The strongest factor association with HCC development was liver cirrhosis (hazard ratio [HR]/95% confidence interval [CI] 9.98/5.11–19.46, P < 0.001), followed by HDV RNA positivity (HR/ CI 5.73/1.35–24.29, P = 0.02), age > 50 years old (HR/CI 3.64/2.03–6.54, P < 0.001), male gender (HR/CI 2.69/1.29–5.60, P: 0.01), and body mass index (BMI, HR/CI 1.11/1.03–1.18, P = 0.004). The 5-year cumulative incidence of HCC was 7.3% for patients with HDV RNA negativity compared to that of 22.2% for patients with HDV RNA positivity (P = 0.01). In the subgroup of cirrhotic patients, the factors associated with HCC development were HDV RNA positivity (HR/CI 4.45/1.04–19.09, P = 0.04) and BMI (HR/CI 1.11/1.03–1.19, P = 0.01). HDV viremia played a crucial role in HCC development in CHB patients who underwent NA therapy.

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