“雙重打擊”聚乙二醇化干擾素-α成功治療了乙型肝炎和丁

StephenW

'Double-hit' pegylated interferon-alpha successfully treats Hepatitis B and Hepatitis D co-infection
Meha Bhuva  1 , Marie Moore  1 , Sambit Sen  1
Affiliations
Affiliation

    1
    Hepatology Department, Luton and Dunstable University Hospital, Luton, UK.

    PMID: 33343908 PMCID: PMC7733525 DOI: 10.1093/omcr/omaa084

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.

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StephenW

“雙重打擊”聚乙二醇化干擾素-α成功治療了乙型肝炎和丁型肝炎的合併感染
Meha Bhuva 1，Marie Moore 1，Sambit Sen 1
隸屬關係
聯繫

    1個
    英國盧頓盧頓和鄧斯特布爾大學醫院肝病科。

    PMID：33343908 PMCID：PMC7733525 DOI：10.1093 / omcr / omaa084

抽象

乙型肝炎（HDV）感染可與現有的乙型肝炎（HBV）同時感染或作為其超級感染。它導致嚴重形式的慢性病毒性肝炎，並加速包括肝細胞癌在內的與肝臟相關的發病率和死亡率。目前的治療方案建議使用聚乙二醇化干擾素-α治療48週，但是持續的病毒學應答（SVR）率仍然很低。我們報導了最初對聚乙二醇化干擾素治療HBV-HDV合併感染有反應的患者。儘管可以看到兩種病毒引起的病毒血症都得到了初步改善，但隨著生化過程中肝臟損傷的不斷進展，仍未達到SVR。然而，兩年後第二療程的聚乙二醇化干擾素的累加作用導致HDV治愈（治療後12個月SVR），極低水平的HBV攜帶者狀態（持續檢測不到病毒載量）和持續的生化正常化。該病例說明了持續性HBV-HDV合併感染的成功治療策略，其中建議的治療方案可引起初始反應，但未實現SVR。

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