Chronic hepatitis B and D (delta) : Current and future treatments

• Published in: Der Internist (Berlin) 2018-06, Vol.59 (6), p.519-527
• Main Authors: Wortmann, N, Höner Zu Siederdissen, C, Cornberg, M
• Format: Article
• Language: ger
• ISSN: 1432-1289
• DOI: 10.1007/s00108-018-0432-3

Worldwide, hepatitis B virus (HBV) infection is among the 30 leading causes of death, despite effective vaccination and therapeutic options. Chronic hepatitis delta (coinfection with hepatitis D virus) leads to a rapid disease progression. Based on current international guidelines and studies, an overview about present and future therapeutic options for chronic hepatitis B and delta is provided. Therapy with nucleoside or nucleotide analogues leads to nearly complete HBV DNA suppression, which is associated with regression of liver fibrosis and a lower risk for the development of hepatocellular carcinoma. Therapy of chronic hepatitis delta with pegylated interferon alfa achieves only low response rates with high risk for virological relapse. Various therapeutic approaches are currently being investigated in preclinical and clinical studies and have led to a significant reduction of hepatitis B surface antigen (HBsAg) and HDV RNA. Current therapies of chronic HBV infection can effectively reduce subsequent complications. New therapeutic approaches promise functional cure (HBsAg loss) of HBV infection and effective treatment options for patients with chronic hepatitis delta.