Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country

Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country

Servais Albert Fiacre Eloumou Bagnaka1, Winnie Tatiana Bekolo Nga1, Gabin Ulrich Kenfack2, Yvanne Getty Bilo’o Mfoula1, Mathurin Kowo2, Christian Tzeuton1, Henry Namme Luma2, Oudou Njoya2, Dominique Noah Noah1, Firmin Ankouane Andoulo2

1Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
2Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon

Open Journal of Gastroenterology and Hepatology

The prevalence of Hepatitis Delta Virus (HDV) infection in Cameroon is 11.01%. Pegylated interferon alpha 2a (PEG-IFN α 2a) is the standard treatment worldwide. This study aimed to describe the virological response to this drug in cameroonians.

Methods: We carried out a cross-sectional study from 1 January 2012 to 31 December 2018. It took place in eleven (11) health facilities of Yaoundé and Douala. Patients with HDV infection and treated with PEG INF α 2a for at least 48 weeks were included. The primary endpoint was Virologic Response (VR) and secondary endpoints were Rapid Virologic Response (RVR) and Late Virologic Response (LVR).

Results: We included 133 patients. The mean age was 36.33 ± 10.9 years. The male sex accounted for 65.41% of cases. The VR was 67.67%.  Leukopenia, fever, headache, asthenia and abdominal pain were the most common adverse events in 88.72%, 68.42%, 53.38%, 45.11% and 35.34% of cases respectively. Factors associated with VR were the presence of diabetes (aOR= 4.32; CI95% [1.22 – 15.30], p= 0.023), fever (aOR= 5.16, CI95% [1.48 – 18.04], p=0.01) and ALT levels greater than 40 IU/l (aOR= 3.69, IC95% [1.15 – 11.18], p= 0.028).

Conclusion: VR is high in cameroonians. The presence of diabetes and elevated transaminases are factors associated with this virologic response. We recommend the use of interferon treatment for patients with HDV infection in Cameroon with very strict monitoring of side effects.

Keywords: Hepatitis Delta virus, Virological Response, Pegylated Interferon alpha 2a, Cameroon.

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Servais Albert Fiacre Eloumou Bagnaka, Winnie Tatiana Bekolo Nga, Gabin Ulrich Kenfack, Yvanne Getty Bilo’o Mfoula, Mathurin Kowo, Christian Tzeuton, Henry Namme Luma, Oudou Njoya, Dominique Noah Noah, Firmin Ankouane Andoulo. Virological response of hepatitis Delta infection to treatment with Pegylated Interferon alpha 2a in a high prevalence country.Open Journal of Gastroenterology and Hepatology, 2020, 3:32. DOI: 10.28933/ojgh-2020-01-2805


2. Butler EK, Rodgers MA, Coller KE, Barnaby D, Krilich E, Olivo A, et al. High prevalence of hepatitis delta virus in Cameroon. Sci Repor (2018) 8:11617
3. Romeo R, Foglieni B, Casazza G, Spreafico M, Colombo M, Prati D. High serum levels of HDV RNA are predictors of cirrhosis and liver cancer in patients with chronic hepatitis delta. PLoS ONE. 21 mars 2014;9(3):e92062.
4. Boyer N, Marcellin P. L’interféron pegylé : nouveau progrès dans le traitement de l’hépatite chronique virale D. 2019;3.
5. Abbas Z, Memon MS, Mithani H, Jafri W, Hamid S. Treatment of chronic hepatitis D patients with pegylated interferon: a real world experience. Antivir Ther. 2014;19(5):463-8.
6. European Association for the Study of the Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012. 2012;57(167):185
7. Heller T, Rotman Y, Koh C, Clark S, Haynes-Williams V, McBurney R, et al. Long term therapy of chronic delta hepatitis with peginterferon alfa. Aliment Pharmacol Ther. juill 2014;40(1):93-104.
8. Sonneveld MJ, Rijckborst V, Boucher CAB, Hansen BE, Janssen HLA. Prediction of sustained response to peginterferon alfa-2b for hepatitis B e antigen-positive chronic hepatitis B using on-treatment hepatitis B surface antigen decline. Hepatology. 9 sept 2010;52(4):1251-7.
9. Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HLY, Chen CJ, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. janv 2016;10(1):1-98.
10. Goulis I, Karatapanis S, Akriviadis E, Deutsch M, Dalekos GN, Raptopoulou-Gigi M, et al. On-treatment prediction of sustained response to peginterferon alfa-2a for HBeAg-negative chronic hepatitis B patients. Liver Int. mai 2015;35(5):1540-8.
11. Terrault NA, Bzowej NH, Chang K-M, Hwang JP, Jonas MM, Murad MH. AASLD guidelines for treatment of chronic hepatitis B: Hepatology, Month 2015. Hepatology. janv 2016;63(1):261-83.
12. Lampertico P, Agarwal K, Berg T, Buti M, Janssen HLA, Papatheodoridis G, et al. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. août 2017;67(2):370-98.
13. Terrault NA, Lok ASF, McMahon BJ, Chang K-M, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. avr 2018;67(4):1560-99.
14. Bahcecioglu IH, Sahin A. Treatment of delta hepatitis: today and in the future – a review. Infect Dis. 3 avr 2017;49(4):241-50.
15. Arnaud P. Les différents interférons : Pharmacologie, mécanismes d’action, tolérance et effets secondaires. Rev Médecine Interne. nov 2002;23:449S-458S.
16. Harris JM, Martin NE, Modi M. Pegylation: A novel process for modifying pharmacokinetics. Clin Pharmacokinet. 2001;40(7):539-51.
17. Wranke A, Wedemeyer H. Antiviral therapy of hepatitis delta virus infection — progress and challenges towards cure. Curr Opin Virol. oct 2016;20:112‑8.
18. Abbas Z, Khan MA, Salih M, Jafri W. Interferon alpha for chronic hepatitis D. Cochrane Hepato-Biliary Group, éditeur. Cochrane Database Syst Rev . 72011;12.
19. Heller T, Rotman Y, Koh C, Clark S, Haynes-Williams V, McBurney R, et al. Long term therapy of chronic delta hepatitis with peginterferon alfa. Aliment Pharmacol Ther. juill 2014;40(1):93-104.
20. Bahcecioglu IH, Ispiroglu M, Demirel U, Yalniz M. Pegylated interferon α therapy in chronic delta hepatitis: a one-center experience. Hepat Mon . 2015;15(3): e24366.
21. Kau A, Vermehren J, Sarrazin C. Treatment predictors of a sustained virologic response in hepatitis B and C. J Hepatol. oct 2008;49(4):634-51.
22. Trabut J-B. Le score Métavir. Hépato-Gastro Oncol Dig. 1 mai 2009;16(3):219-20.
23. Luma HN, Eloumou SAFB, Okalla C, Donfack-Sontsa O, Koumitana R, Malongue A, et al. Prevalence and characteristics of hepatitis delta virus infection in a tertiary hospital setting in Cameroon. J Clin Exp Hepatol. déc 2017;7(4):334-9.
24. Bagnaka Eloumou SAF, Namme Luma H, Noah Noah D, Nko’Ayissi G B, Malongue A, Noubiap N J J et al. Clinicopathological characteristic of a group of sub-saharian African patients with chronic hepatitis B infection: a gender analysis. GHOA. Dec 2016;5(8): 1-6.
25. Stockdale AJ, Chaponda M, Beloukas A, Phillips RO, Matthews PC, Papadimitropoulos A, et al. Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health. oct 2017;5(10):e992‑1003.
26. Gilman C, Heller T, Koh C. Chronic hepatitis delta: a state-of-the-art review and new therapies. World J Gastroenterol. 2019 Aug 28;25(32):4580-4597. doi: 10.3748/wjg.v25.i32.4580.
27. Botelho-Souza LF, Vasconcelos MPA, Dos Santos AO, Salcedo JMV, Vieira DS. Hepatitis delta: virological and clinical aspects. Virol J. 2017 Sep 13;14(1):177. doi: 10.1186/s12985-017-0845-y.
28. Rizzetto M. The adventure of delta. Liver Int. Jan 2016; 36:135-40.
29. Ormeci N, Bölükbaş F, Erden E, Coban S, Ekiz F, Erdem H, et al. Pegylated interferon alfa-2B for chronic delta hepatitis: 12 versus 24 months. Hepatogastroenterology. oct 2011;58(110‑111):1648-53.

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