Medication Summary

Antiviral therapy with interferon alfa can be considered in patients with chronic hepatitis D virus (HDV) infection. The treatment course is usually at least 1 year. Treating children with interferon alfa seems to be safe but is relatively ineffective. Treatment is not needed for patients with coinfection, given the high spontaneous clearance rates. Lamivudine, ribavirin, and corticosteroids have not been effective in treatment.

Class Summary

These are naturally produced proteins with antiviral, antitumor, and immunomodulatory actions.

Interferon alfa-2a (Roferon)

Interferon alfa-2a has been used in several small studies to treat hepatitis D virus (HDV) infection. Dosages varying from 3-10 mU 3 times per week for as long as 12 months have been used. At the end of therapy, loss of HDV RNA and normalization of liver enzymes was seen in 50% of patients treated with 9 mU 3 times per week and in 21% in those treated with 3 mU. Half the responders remained in biochemical remission after the cessation of therapy, while no patients maintained a virologic response after cessation. Histologic improvement was observed in patients treated with interferon.

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Media Gallery

Algorithm for the evaluation of chronic hepatitis D. Courtesy of Gastroenterology Report (Shah PA, Choudhry S, Reyes KJC, Lau DTY. An update on the management of chronic hepatitis D. Gastroenterol Rep (Oxf). 2019 Oct 19;7(6):396-402. PMID: 32494363; PMCID: PMC7249531).
Algorithm for the treatment of chronic hepatitis D. Courtesy of Gastroenterology Report (Shah PA, Choudhry S, Reyes KJC, Lau DTY. An update on the management of chronic hepatitis D. Gastroenterol Rep (Oxf). 2019 Oct 19;7(6):396-402. PMID: 32494363; PMCID: PMC7249531).

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Author

Praveen K Roy, MD, MSc Clinical Assistant Professor of Medicine, University of New Mexico School of Medicine

Praveen K Roy, MD, MSc is a member of the following medical societies: Alaska State Medical Association, American Gastroenterological Association

Disclosure: Nothing to disclose.

Coauthor(s)

Rahaman Mujibur, MD Academic Hospitalist/Hospitalist, Marshfield Clinic, St Joseph’s Hospital

Rahaman Mujibur, MD is a member of the following medical societies: American College of Physicians, American Medical Association, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Rajan Kanth, MD Gastroenterologist, WellSpan Health

Rajan Kanth, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Nepal Medical Association, Society of Hospital Medicine

Disclosure: Nothing to disclose.

Sean R Lacey, MD Associate Professor of Gastroenterology, Pennsylvania State University College of Medicine; Staff Physician, Division of Gastroenterology, Lehigh Valley Hospital and St Luke's Hospital

Sean R Lacey, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association

Disclosure: Nothing to disclose.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Acknowledgements

David Eric Bernstein, MD Director of Hepatology, North Shore University Hospital; Professor of Clinical Medicine, Albert Einstein College of Medicine

David Eric Bernstein, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment