Treatment of chronic hepatitis due to hepatitis B and hepatitis delta virus coinfection

•Hepatitis delta virus (HDV) infection rapidly evolves towards liver cirrhosis and hepatocellular carcinoma.•Interferon-based therapies have a modest impact on chronic HDV infection.•HDV offers no target for conventional antiviral agents.•Novel targets are virus entry, prenylation inhibition and HBs...

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Bibliographic Details
Published in:International journal of antimicrobial agents 2019-12, Vol.54 (6), p.697-701
Main Authors: Brancaccio, Giuseppina, Gaeta, Giovanni B.
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Coinfection
Entry inhibitor
HBsAg release blocker
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - drug therapy
Hepatitis D, Chronic - complications
Hepatitis D, Chronic - drug therapy
Hepatitis delta virus
Humans
IFN-lambda
Peg-IFN
Prenylation inhibitor
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Summary:•Hepatitis delta virus (HDV) infection rapidly evolves towards liver cirrhosis and hepatocellular carcinoma.•Interferon-based therapies have a modest impact on chronic HDV infection.•HDV offers no target for conventional antiviral agents.•Novel targets are virus entry, prenylation inhibition and HBsAg secretion. An estimated 20–40 million individuals worldwide are infected with hepatitis delta virus (HDV), mostly with rapidly evolving liver disease. Therapy of chronic HDV infection remains an unmet need. To date, only interferon (IFN)-based therapy is recommended for HDV infection and response rates are unsatisfactory; in addition, many patients are intolerant to or ineligible for IFN treatment. In recent years, innovative approaches have been in development, including the following: targeting virus entry into hepatocytes; inhibition of the host enzyme farnesyltransferase by prenylation inhibitors, leading to inhibition of complete virion formation and release; blockade of hepatitis B surface antigen (HBsAg) secretion, inhibiting virus release; and IFN-lambda, which causes fewer adverse effects than IFN-alfa. Clinical trials are ongoing with encouraging preliminary results.
ISSN:0924-8579
1872-7913
DOI:10.1016/j.ijantimicag.2019.09.012