Browsing by Author "Dalekos, George Nikolaos"
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Item Quantitative HBsAg and HDV-RNA levels in chronic delta hepatitis(Wiley, 2010-03) Zachou, Kalliopi; Yurdaydın, Cihan; Drebber, Uta; Dalekos, George Nikolaos; Erhardt, Andreas; Çakaloğlu, Yılmaz; Değertekin, Halil; Zeuzem, Stefan S.; Bozkaya, Hakan; Schlaphoff, Verena; Dienes, Hans Peter; Bock, C. Thomas; Manns, Michael Peter; Wedemeyer, Heiner; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 7003706434Background: Hepatitis delta virus (HDV) causes severe liver disease. Aims: To investigate the quantitative HDV-RNA, HBsAg and hepatitis B virus (HBV)DNA levels in correlation to histological, biochemical and demographical parameters in patients with chronic HDV infection as similar data in a large series of HDV patients are missing. Methods: Eighty HDV patients were recruited in Germany, Turkey and Greece; quantitative determination of HDV-RNA, HBsAg and HBV-DNA was performed by real-time polymerase chain reaction, the Architect HBsAg assay and Cobas TaqMan HBV test respectively. Results: All patients were infected with HDV-genotype 1. Thirty-five patients (48%) had significant fibrosis (Ishak 3-4) and 15 (20.5%) had cirrhosis. HDV viraemia ranged from 1.1 x 10(3) to 8.4 x 10(7) copies/ml with 60% of patients showing HDV-RNA levels above 105 copies/ml accompanied by low HBV viraemia (<10(5) copies/ml). However, HDV-RNA and HBV-DNA levels showed no direct inverse correlation. HDV-RNA correlated positively with HBsAg and negatively with age. HBsAg correlated negatively with age and positively with histological grading. Only gamma-glutamyltranspeptidase was independently associated with cirrhosis (P=0.032), while no biochemical parameter was associated with grading. Conclusions: (i) HBsAg levels correlated with HDV viraemia in chronic HDV. (ii) Biochemical parameters did not accurately indicate the stage and grade of liver disease in chronic HDV and thus liver biopsy seems to remain the major tool for the evaluation of delta hepatitis patients.Item Renal function during treatment with adefovir plus peginterferon alfa-2a vs either drug alone in hepatitis B/D co-infection(Wiley, 2012-06) Mederacke, Ingmar; Yurdaydın, Cihan; Grosshennig, Anika; Erhardt, Andreas; Çakaloğlu, Yılmaz; Yalçın, Kendal; Zeuzem, Stefan; Zachou, Kalliopi; Chatzikyrkou, Christos; Bozkaya, Hakan; Dalekos, George Nikolaos; Manns, Michael Peter; Wedemeyer, Heiner; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi.; 7003706434Long-term safety of treatment with hepatitis B virus (HBV) polymerase inhibitors is a concern. Adefovir dipivoxil (ADV) therapy has previously been associated with impairment of renal function. Limited data are available on the safety of combination therapy with nucleos(t)ide analogues and interferon alfa (IFNa). The aim of this analysis was to assess the renal function during combination therapy with peginterferon alfa-2a (PegIFNa-2a) plus ADV vs either drug alone in patients with hepatitis B/D co-infection. We performed a retrospective analysis of renal function data of patients treated in the Hep-Net/International Delta Hepatitis Intervention Trial 1(HIDIT-1-trial), a European multicenter study to investigate the efficacy of 48 weeks of therapy with PegIFNa-2a+ADV vs either drug alone in 90 patients with chronic hepatitis B/D co-infection. Glomerular filtration rates (GFR) were calculated by CockcroftGault (CG), abbreviated Modification of Diet in Renal Disease (MDRD) study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. After 48 weeks of therapy GFR values were significantly lower in patients receiving adefovir-containing treatment vs PegIFNa-2a alone [mean difference 16.1 mL/min (CG) and 10.2 mL/min (MDRD), respectively, P < 0.05] while no differences were observed between patients receiving adefovir alone vs combination treatment. Twenty-four weeks after treatment GFR values did not differ between treatment arms. A decrease in GFR =20% was observed more often in patients during adefovir-containing treatment vs PegIFNa-2a alone (P < 0.05) which was confirmed by KaplanMeier analysis. Adefovir-containing but not PegIFNa-2a treatment was associated with a decrease in GFR values in about one-fifth of patients. Combination treatment of PegIFNa-2a+ADV in chronic hepatitis B/D co-infection did not lead to any further impairment of kidney function.