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

Abstract

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 Yaounde 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.