Anika Wranke1, Lourdes M Pinheiro Borzacov2, Raymundo Parana3, Cirley Lobato4, Saeed Hamid5, Emanoil Ceausu6, George N Dalekos7, Mario Rizzetto8, Adela Turcanu9, Grazia A Niro10, Farheen Lubna5, Minaam Abbas11, Patrick Ingiliz12, Maria Buti13, Peter Ferenci14, Thomas Vanwolleghem15, Tonya Hayden16, Naranjargal Dashdorj17, Adriana Motoc6, Markus Cornberg1,18, Zaigham Abbas11, Cihan Yurdaydin19, Michael P Manns1,18, Heiner Wedemeyer1,18, Svenja Hardtke1,18. 1. Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 2. Research Centre for Tropical Medicine of Rondônia - CEPEM/SESAU, Federal University of Rondônia, Rondônia, Brazil. 3. Hepatology Centre of the University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador, Brazil. 4. Hospital das Clínicas do Acre, Rio Branco, Brazil. 5. Department of Hepatogastroenterology, Aga Khan University, Karachi, Pakistan. 6. Infectious Diseases, Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Bucharest, Romania. 7. Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece. 8. Department of Internal Medicine - Gastroenterology, University of Torino, Torino, Italy. 9. State University of Medicine "Nicolae Testemitanu", Chisinau, Republic of Moldova. 10. Divisione di Gastroenterologia, Ospedale Generale Regionale "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy. 11. Ziauddin University Hospital Karachi, Karachi, Pakistan. 12. Centre for Infectiology Berlin (CIB), Berlin, Germany. 13. Liver Unit, Valle d'Hebron University Hospital and Ciberhed del Instituto CarlosIII, Barcelona, Spain. 14. Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria. 15. Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium. 16. Centres for Disease Control and Prevention/Div of viral hepatitis, Atlanta, USA. 17. Onom Foundation, Ulaanbaatar, Mongolia. 18. German Centre for Infection Research (DZIF), HepNet Study-House, Hannover, Germany. 19. Medical Faculty, Ankara University, Ankara, Turkey.
Abstract
BACKGROUND & AIMS: Chronic hepatitis D (delta) is a major global health burden. Clinical and virological characteristics of patients with hepatitis D virus (HDV) infection and treatment approaches in different regions world-wide are poorly defined. METHODS: The Hepatitis Delta International Network (HDIN) registry was established in 2011 with centres in Europe, Asia, North- and South America. Here, we report on clinical/ virological characteristics of the first 1576 patients with ongoing or past HDV infection included in the database until October 2016 and performed a retrospective outcome analysis. The primary aim was to investigate if the region of origin was associated with HDV replication and clinical outcome. RESULTS: The majority of patients was male (n = 979, 62%) and the mean age was 36.7 years (range 1-79, with 9% of patients younger than 20 years). Most patients were HBeAg-negative (77%) and HDV-RNA positive (85%). Cirrhosis was reported in 48.7% of cases which included 13% of patients with previous or ongoing liver decompensation. Hepatocellular carcinoma (HCC) developed in 30 patients (2.5%) and 44 (3.6%) underwent liver transplantation. Regions of origin were independently associated with clinical endpoints and detectability of HDV RNA. Antiviral therapy was administered to 356 patients with different treatment uptakes in different regions. Of these, 264 patients were treated with interferon-a and 92 were treated with HBV-Nucs only. CONCLUSIONS: The HDIN registry confirms the severity of hepatitis delta but also highlights the heterogeneity of patient characteristics and clinical outcomes in different regions. There is an urgent need for novel treatment options for HDV infection.
BACKGROUND & AIMS:Chronic hepatitis D (delta) is a major global health burden. Clinical and virological characteristics of patients with hepatitis D virus (HDV) infection and treatment approaches in different regions world-wide are poorly defined. METHODS: The Hepatitis Delta International Network (HDIN) registry was established in 2011 with centres in Europe, Asia, North- and South America. Here, we report on clinical/ virological characteristics of the first 1576 patients with ongoing or past HDV infection included in the database until October 2016 and performed a retrospective outcome analysis. The primary aim was to investigate if the region of origin was associated with HDV replication and clinical outcome. RESULTS: The majority of patients was male (n = 979, 62%) and the mean age was 36.7 years (range 1-79, with 9% of patients younger than 20 years). Most patients were HBeAg-negative (77%) and HDV-RNA positive (85%). Cirrhosis was reported in 48.7% of cases which included 13% of patients with previous or ongoing liver decompensation. Hepatocellular carcinoma (HCC) developed in 30 patients (2.5%) and 44 (3.6%) underwent liver transplantation. Regions of origin were independently associated with clinical endpoints and detectability of HDV RNA. Antiviral therapy was administered to 356 patients with different treatment uptakes in different regions. Of these, 264 patients were treated with interferon-a and 92 were treated with HBV-Nucs only. CONCLUSIONS: The HDIN registry confirms the severity of hepatitis delta but also highlights the heterogeneity of patient characteristics and clinical outcomes in different regions. There is an urgent need for novel treatment options for HDV infection.
Authors: Mohamed A Daw; Amina M Daw; Nadia E M Sifennasr; Aisha M Draha; Ahmed M Daw; Ali M Daw; Mohamed O Ahmed; Ebtisam S Mokhtar; Abdallah El-Bouzedi; Ibrahem M Daw Journal: ScientificWorldJournal Date: 2018-09-26