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Therapy of Delta Hepatitis
Cihan Yurdaydin1, Ramazan Idilman2
1Department of Gastroenterology, University of Ankara Medical School, Ankara 06100, Turkey Hepatology Institute, University of Ankara, Ankara 06100, Turkey.
Cold Spring Harbor Perspectives in Medicine
|August 9, 2015
Summary
Delta hepatitis, a severe viral liver disease, requires effective treatments. Current management involves interferon, but new therapies targeting the hepatitis delta virus (HDV) life cycle are emerging.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Delta hepatitis, caused by hepatitis delta virus (HDV) and hepatitis B virus (HBV), is a severe liver disease.
- Acute delta hepatitis coinfection is rare but can lead to fulminant hepatitis with no current therapy.
- Chronic delta hepatitis (CDH) often results from HBV carriers superinfected with HDV.
Purpose of the Study:
- To review the current management of chronic delta hepatitis (CDH).
- To discuss treatment efficacy markers and challenges in CDH.
- To highlight the need for novel therapeutic strategies for HDV infection.
Main Methods:
- Review of existing literature on delta hepatitis management.
- Analysis of treatment outcomes and surrogate markers.
- Discussion of emerging therapeutic targets for HDV.
Main Results:
- Interferon therapy is the primary treatment for CDH, requiring at least 1 year.
- Post-treatment week-24 virologic response is a marker but not indicative of sustained response.
- Anti-HDV-IgM correlates with outcomes but HDV RNA is more sensitive for treatment response.
- Hepatitis B virus (HBV) may become dominant in rare cases, allowing nucleos(t)ide analog therapy.
Conclusions:
- No evidence-based guidelines exist for CDH treatment duration; individualization is key.
- Effective CDH treatment can reduce liver complications and mortality.
- Interferons are contraindicated in decompensated cirrhosis; liver transplantation is considered.
- Novel therapies targeting the HDV life cycle are under development, offering future hope.
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