Heiner Wedemeyer.

Study Population Individuals between 18 and 70 years who had HDV infection were qualified to receive inclusion if indeed they had compensated liver disease, had been positive for HBsAg for in least 6 months and positive for anti-HDV antibodies for in least 3 months, and were positive for HDV RNA on polymerase-chain-reaction assay. A explanation of the eligibility criteria are available in the Supplementary Appendix and in the study protocol, both available with the entire text of this article at NEJM.org. The study was conducted relative to the protocol. Study Design Patients were stratified according to nation and presence or lack of a history of interferon treatment before undergoing randomization to 1 of three treatment groupings, plus they received the assigned medication for 48 weeks.In most cases, patients continued their pretransplantation antiretroviral regimen. Doses of renally administered medicines depended on the amount of kidney function, with frequent modifications in the early post-transplantation period and during periods of graft dysfunction. Potential nephrotoxicity of antiretroviral agents and agents used to prevent opportunistic infection was considered, and medicines were transformed as indicated. Prophylaxis against opportunistic infection included lifelong therapy to prevent Pneumocystis jiroveci pneumonia, fluconazole for antifungal prophylaxis, and valganciclovir or ganciclovir to avoid cytomegalovirus infection . Macrolide prophylaxis against Mycobacterium avium complex was required once the CD4+ T-cell count dropped below 75 cells per cubic millimeter.