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Updated: Sep 9, 2025
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Updates on Recent Advancements in Hepatitis D Virus Treatment
Ali Emre Bardak1, Nazli Begum Ozturk2, Merve Gurakar3
1Department of Medicine, Boston Medical Center-Brighton, Boston, MA 02135, USA.
Insights
Hepatitis D virus (HDV) infection causes severe liver disease in hepatitis B virus (HBV) patients. This review updates on new treatments beyond interferon-alfa, including bulevirtide, for better HDV management.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis D virus (HDV) infection significantly worsens liver disease in hepatitis B virus (HBV) patients, accelerating cirrhosis and hepatocellular carcinoma.
- Current first-line therapy, pegylated interferon-alfa, has limited efficacy, poor response durability, and significant side effects for HDV.
- The lack of effective treatments highlights the urgent need for novel therapeutic strategies.
Purpose of the Study:
- To provide an overview of recent advancements in the treatment of chronic Hepatitis D virus infection.
- To discuss emerging novel therapies and their potential impact on managing HDV.
- To highlight the evolving landscape of HDV treatment options.
Main Methods:
- This review synthesizes current literature on Hepatitis D virus (HDV) treatment.
- It focuses on approved therapies and those in clinical investigation.
- Key advancements and challenges in HDV therapy are discussed.
Main Results:
- Pegylated interferon-alfa is the current standard but has limitations.
- Bulevirtide, an entry inhibitor, is the first approved agent for chronic HDV by the EMA.
- Several other promising therapies are under investigation.
Conclusions:
- The treatment landscape for Hepatitis D virus infection is evolving with new therapeutic options.
- Bulevirtide represents a significant advancement, with further novel agents in development.
- Improved treatment strategies are crucial for better outcomes in patients with chronic HDV infection.
Abstract:
Hepatitis D virus (HDV) infection remains a major cause of severe liver disease among hepatitis B virus (HBV)-infected patients, contributing to accelerated progression to cirrhosis and hepatocellular carcinoma. Pegylated interferon-α remains the first-line therapy for chronic HDV infection in most cases. However, despite its approval for HBV and hepatitis C virus (HCV) infections, its use in HDV is largely driven by a lack of other options and is constrained by its limited efficacy, suboptimal durability of response, and a substantial side effect profile. Meanwhile, bulevirtide, an entry inhibitor, became the first agent to be approved for use in chronic HDV infections by the European Medicines Agency (EMA), and several other therapies are currently being investigated as well. In this review, we provide updates on recent advancements in HDV treatment and novel therapies.
