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Chronic hepatitis D at a standstill: where do we go from here?
Alessia Ciancio1, Mario Rizzetto1
1Division of Gastroenterology, University of Torino, Molinette Hospital, Corso Bramante 88, Torino 10126, Italy.
Nature Reviews. Gastroenterology & Hepatology
|September 11, 2013
Summary
Hepatitis D virus (HDV) infection is a growing concern globally, particularly with immigration. Current treatments focus on optimizing interferon-alpha (IFN-α) therapy, with new strategies targeting viral and host interactions.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis D virus (HDV) poses a significant global health challenge, with increasing prevalence in Europe due to immigration and ongoing issues in the USA and developing nations.
- HDV infection necessitates novel therapeutic strategies due to its association with Hepatitis B virus (HBV) and complex host interactions.
Approach:
- Investigating new therapeutic strategies to disrupt HDV-HBV interactions and host-dependent viral processes.
- Exploring the potential of blocking or modifying hepatitis B surface antigen (HBsAg) to inhibit HDV virion uptake or release.
- Examining host-mediated post-translational modifications, such as prenylation, as targets for therapeutic intervention.
Key Points:
- Current primary treatment involves optimizing interferon-alpha (IFN-α) therapy.
- Long-term IFN-α administration may be necessary for HBsAg eradication, posing challenges related to patient tolerance.
- Interferon-lambda (IFN-λ) is a potential alternative to IFN-α, showing fewer adverse effects in Hepatitis C treatment and suitability for long-term HDV therapy.
Conclusions:
- New therapeutic avenues for HDV infection are under development, targeting viral and host factors.
- Optimizing IFN-α therapy remains the current standard, but long-term use requires careful consideration of tolerance.
- IFN-λ presents a promising alternative for long-term HDV treatment due to a potentially better safety profile.
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