29. Treatment of Hepatitis D

  1. Howard C. Thomas BSc, PhD, FRCP, FRCPath, FMedSci3,
  2. Anna S.F. Lok MD4,
  3. Stephen A. Locarnini MBBS, BSc(Hons), PhD, FRCPath5 and
  4. Arie J. Zuckerman MD, DSc, FRCP, FRCPath, FMedSci6
  1. Alessia Ciancio1 and
  2. Mario Rizzetto2

Published Online: 26 JUL 2013

DOI: 10.1002/9781118637272.ch29

Viral Hepatitis, Fourth Edition

Viral Hepatitis, Fourth Edition

How to Cite

Ciancio, A. and Rizzetto, M. (2013) Treatment of Hepatitis D, in Viral Hepatitis, Fourth Edition (eds H. C. Thomas, A. S.F. Lok, S. A. Locarnini and A. J. Zuckerman), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118637272.ch29

Editor Information

  1. 3

    Emeritus Professor of Hepatology, Department of Medicine, Imperial College London, London, UK

  2. 4

    Alice Lohrman Andrews Research Professor in Hepatology, Director of Clinical Hepatology, Professor of Internal Medicine, Associate Chair for Clinical Research, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA

  3. 5

    Head, Research & Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia

  4. 6

    Emeritus Professor of Medical Microbiology, Formerly Principal and Dean, Royal Free Hospital School of Medicine

Author Information

  1. 1

    University of Torino, Torino, Italy

  2. 2

    Molinette Hospital, Torino, Italy

Publication History

  1. Published Online: 26 JUL 2013

ISBN Information

Print ISBN: 9780470672952

Online ISBN: 9781118637272



  • chronic hepatitis D;
  • hepatitis D virus;
  • interferon;
  • pegylated interferon alpha (PEG-IFNα);
  • hepatitis therapy;
  • hepatitis D therapy


Interferon is the only therapy with demonstrated efficacy for chronic hepatitis D. Nucleos(t)ide analogs against the hepatitis B virus (HBV) are not efficacious as they do not eradicate the underlying HBV that supports hepatitis D virus (HDV) infection. The current therapeutic recommendation is pegylated interferon alpha (PEG-IFNα) given weekly for 12 to 18 months. Response is limited. Serum HDVRNA is undetectable 6 months post therapy in only about one-quarter of patients; however, HDV may relapse in these patients as long as they remain HBsAg-positive. The only reliable endpoint of therapy is the clearance of hepatitis B surface antigen (HBsAg). The current management of HDV patients is based on common practice rather than on evidence from clinical trials; therefore, it should be pragmatic and individualized. Therapy lasting longer than 12 months might be of benefit in selected patients with partial responses or in those with rapidly advancing disease.