Divulgação, Notícias

Discussions about new protocol for delta hepatitis advance

PEGylated interferon could become the first choice to treat the disease


The Congress of the BSTM, will host a round table on delta hepatitis and the elaboration of a multicenter project between the states from the North region to study the clinical aspect and therapeutic response of the drugs recommended by the HMs protocol

Hepatitis D, also known as delta, has few effective therapy options. However, a new treatment protocol advances and could include PEGylated interferon as first choice to treat the disease, possibly extending its use for a period longer than usual, which today is 48 weeks.

In Brazil, double and triple therapies with PEGylated interferon for 48 weeks are available since 2012 to treat hepatitis C.

The subject was discussed in March in the Health Ministry (HM), in a meeting aiming to discuss the new Clinical Protocol Guideline (CPG) for hepatitis B and co-infections. The group was formed by members of the national committee of viral hepatitis experts, representatives of the civil and scientific societies, as well as the Boards technical staff.

One of the participants of the meeting, Doctor Wornei Braga, PhD in Tropical Medicine, said the group is trying to find a more adequate and viable solution by elaborating a document able to translate both the current scientific reality and social impact aspects and public accounting to treat viral hepatitis in patients from the Unified Health System (SUS).

In my opinion, the current political scenario and the economy crisis stopped us from advancing, at this moment, in the diagnostic recommendations, treatment and handling of hepatitis delta, as we achieved for hepatitis C and B, said Doctor Wornei.

Regarding the debate on hepatitis delta, the physician said the first point to be discussed was the impossibility to have serological or molecular confirmation, in the SUS routine. This is because the IgM (Immunoglobulin M) manufacturer, the present infection confirmation test, only delivers the kit under demand and is not interested in registering it in Brazil.

According to Dr. Wornei, the diagnostic is then based on clinical evidences of advanced chronic disease and reactive serology for HBsAg and anti-HDV IgG. Due to budget issues it was not possible to incorporate the HBsAg quantitative test in the prediction of the sustained viral response and therapy response, he said.

The disease is caused by the D (VHD) virus, depending on the presence of the B-type virus to infect a person. Most times it manifests the same way as acute hepatitis B.

Next meetings

New meetings are to be held to review the hepatitis C CPG, since it is being reviewed in Europe and in the USA, according to Dr. Wornei. Regarding hepatitis delta, a workgroup was created to search for mechanisms able to, in a long term, correct the current protocols distortions.

We agreed to seek partnerships with research institutions and scientific societies. Responding to an invitation by the current chair of the Brazilian Society of Tropical Medicine (BSTM), Marcus Lacerda, we agreed to host a round table in the Congress in Maceió to talk about hepatitis delta and the elaboration of a multicenter project between the states from the North region to study the clinical aspects and therapy response to the drugs recommended by the HM, he said.…