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Chronic Hepatitis D Virus Infection and Its Treatment: A Narrative Review

Poonam Mathur1, Arshi Khanam1, Shyam Kottilil1

  • 1Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

Microorganisms
|November 27, 2024
PubMed

Insights

Hepatitis D virus (HDV) infection is severe, accelerating liver disease. New antivirals, like buleviritide and lonafarnib, show promise in combination with pegylated interferon (PEG-IFN) for better HDV suppression.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis D virus (HDV) infection is the most severe form of viral hepatitis, necessitating hepatitis B virus (HBV) co-infection.
  • HDV infection accelerates liver disease progression, leading to cirrhosis and hepatocellular carcinoma.
  • Current treatments lack reliable HDV eradication and have limited efficacy and tolerability.

Purpose of the Study:

  • To discuss the characteristics of HDV infection.
  • To review existing and novel antiviral therapies for HDV.
  • To highlight the potential of new agents in combination therapy.

Main Methods:

  • Review of current literature on HDV infection and its management.
  • Analysis of the mechanisms of action for novel antiviral therapies.
  • Discussion of clinical trial data for emerging HDV treatments.

Main Results:

  • Pegylated interferon (PEG-IFN) is the only approved treatment, suppressing HDV RNA but with low cure rates and adverse effects.
  • Newer antivirals targeting HDV entry (bulevirtide), assembly (lonafarnib), and export (REP-2139) show promising results.
  • Combination therapies with PEG-IFN and novel agents aim for improved long-term HDV RNA suppression.

Conclusions:

  • Effective and tolerable treatments for chronic HDV infection are urgently needed.
  • Emerging antiviral therapies offer new hope for managing HDV infection.
  • Combination strategies may be key to achieving sustained viral suppression and improving patient outcomes.

Keywords:
hepatitishepatitis D virustreatment

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