聚乙二醇干扰素降低HDV RNA 24周后

StephenW

Pegylated interferon lowers HDV RNA after 24 weeks

Keskin O, et al. Clin Gastroenterol Hepatol. 2015;doi:10.1016/j.cgh.2015.05.029.
December 3, 2015

   

Analysis of data from the Hep-Net-International Delta Hepatitis Intervention Trial showed that pegylated interferon lowered hepatitis D virus RNA, with or without adefovir, and predicted clearance rate 24 weeks post-treatment.

Data of 50 patients with compensated liver disease and positive for anti-HDV and HDV RNA were treated with pegylated interferon alpha 2a and adefovir, adefovir alone or placebo for 48 weeks. Of these patients, 41 were evaluated for various parameters 24 weeks after treatment, including measurement of HDV RNA level, liver enzymes, and hepatitis B surface antigen (HBsAg).

According to univariate and multivariate analyses, the researchers found that HDV RNA serum at 24 weeks of therapy was associated more closely with a response to therapy than other factors. HBsAg serum at 24 weeks was found to be associated with a response to treatment only in univariate analysis.

Univariate analysis also showed that patients with an end of treatment virologic response had a greater baseline histology activity score compared with patients who did not experience virologic response. The patients who reached a viroloigc response had lower mean HDV RNA serum levels at 24 weeks compared with nonresponders, as well as had a greater likelihood to have a decrease in HBsAg serum compared with patients who did not reach an end of treatment virologic response.

Using the area under receiver operating characteristic curve (AUROC) for predictive analysis, the AUC for HDV RNA levels at 24 weeks of treatment was 0.862 for predicting a virologic response 24 weeks after the end of treatment.

Positive predictors for the absence of HDV RNA at 24 weeks of therapy (71%) and end of treatment (100%) were also identified using AUROC.

At 24 weeks post-treatment, a decrease in HDV RNA serum of less than 1 log with no decrease in HBsAg serum showed null responders with a positive predictive value of 83%. In addition, a decrease in HDV RNA level greater than 2 log at 24 weeks of therapy “identified null responders with a negative predictive value of 95%,” according to the data.

“The main finding of this analysis was that on-treatment week 24 HDV RNA is suited for treatment outcome prediction,” the researchers wrote.

The researchers concluded: “We believe that these findings, short of providing solid prediction rules, nevertheless can help physicians treating [chronic delta hepatitis] patients for better orientation regarding when to decide to continue or stop pegylated interferon treatment.” – by Melinda Stevens

Disclosures: Keskin reports no relevant financial disclosures. Please see the study for a full list of all other authors’ relevant financial disclosures.

StephenW

聚乙二醇干扰素降低HDV RNA 24周后

Keskin的0，等。临床Gastroenterol肝脏病。 2015年，DOI：10.1016 / j.cgh.2015.05.029。
2015年12月3日

   

从酷净国际三角洲肝炎干预试验数据的分析表明，聚乙二醇化干扰素降低丁型肝炎病毒的RNA，有或没有阿德福韦，并预测清除率后24周的治疗。

50例代偿性肝病和积极的抗HDV和HDV RNA数据用聚乙二醇化干扰素α2a和阿德福韦，阿德福韦单独或安慰剂治疗48周。在这些患者中，41进行了评价的各种参数治疗后24周，包括测量HDV RNA水平，肝酶和B型肝炎表面抗原（HBsAg）。

根据单因素和多因素分析，研究人员发现，在24周的治疗HDV RNA血清关联更加紧密地与疗法比其他因素的响应。 HBsAg的血清在24周被认为是与仅仅在单变量分析对治疗的应答​​相关联。

单因素分析还显示，患者的治疗病毒学应答结束了较大的基线组织学活动评分与患者谁没有经历过病毒学应答相比。谁达到viroloigc响应的患者有更低的平均HDV核糖核酸血清水平在24周与无反应者比较，以及有一个更大的可能性为具有降低的HBsAg血清与患者谁没有达到治疗病毒学应答的一端相比较。

使用下ROC曲线（AUROC），用于预测分析领域，AUC为HDV RNA水平在治疗24周为0.862，用于预测治疗结束后24周的病毒学应答。

还确定了使用AUROC阳性预测为不存在的HDV的RNA在治疗（71％）和处理（100％）的端部24周。

在24周治疗后，在小于1的日志与在HBsAg的血清没有降低HDV核糖核酸血清的降低表明无应答为83％，阳性预测值。此外，减少了以HDV RNA水平大于2个对数，在24周的治疗“确定零应答为95％，阴性预测值为”，根据该数据。

“这种分析的主要发现是，在治疗24周HDV RNA是适合于治疗结果的预测，”研究人员写道。

研究人员得出结论：“我们认为，这些发现提供了坚实的预测规则的短，但是可以帮助医生治疗[慢性肝炎三角洲]患者关于何时决定继续或停止聚乙二醇干扰素治疗更好的方向。” - 由梅琳达·史蒂文斯

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