Current treatment options for hepatitis D are limited,with pegylated interferonalpha(PEG-IFNα)being the only therapy available in the Asia-Pacific region.However,PEG-IFNαhas limited efficacy and significant side eff...Current treatment options for hepatitis D are limited,with pegylated interferonalpha(PEG-IFNα)being the only therapy available in the Asia-Pacific region.However,PEG-IFNαhas limited efficacy and significant side effects.Pegylated interferon lambda acts on interferon-lambda(Type III)receptors predominantly expressed in hepatocytes.In 2023,bulevirtide was approved in the European Union and Russia for treating chronic hepatitis D.This drug works by binding to and inhibiting the sodium taurocholate co-transporting polypeptide receptor on liver cells,which is the primary entry point for the virus.Recently,several new drugs have entered various stages of development,offering hope for improved hepatitis D virus(HDV)management.Two more viral entry inhibitors are HH003 and tobevibart.Other agents include nucleic acid polymers(REP 2139-Mg),prenylation inhibitors(lonafarnib),and RNA interference-based therapies(elebsiran).Emerging trials are now considering combination therapies,such as SOLSTICE,a Phase 2 clinical trial evaluating tobevibart alone or combined with elebsiran.The combination dosed monthly achieved>50%virologic and biochemical response at 24 weeks of therapy.The efficacy and safety of these drugs will further be evaluated in ECLIPSE 1,2,and 3 trials.With these new treatments on the horizon,the prospects for improved HDV patient outcomes are promising.展开更多
研究洛那法尼(Lonafarnib,LNF)对动物源丁型肝炎病毒(Hepatitis D virus,HDV)的影响,将完善对动物源HDV的认识,为进一步探讨其潜在致病性和传播特点奠定基础。利用点突变的方法对人源HDV复制模型进行改造来模拟动物源HDV的关键结构特征...研究洛那法尼(Lonafarnib,LNF)对动物源丁型肝炎病毒(Hepatitis D virus,HDV)的影响,将完善对动物源HDV的认识,为进一步探讨其潜在致病性和传播特点奠定基础。利用点突变的方法对人源HDV复制模型进行改造来模拟动物源HDV的关键结构特征,利用转染、抗生素筛选的方法构建模拟的动物源HDV复制细胞模型,蛋白质免疫印迹法和间接免疫荧光法检测人源HDV复制模型改造后的HDV复制与蛋白表达情况,实时荧光定量PCR检测LNF对动物源HDV复制的影响。结果表明,改造后的HDV复制模型仍能在体外高效复制,可用于模拟动物源HDV的关键特征。与未处理组相比,LNF处理人源HDV复制模型后导致了HDV RNA的积累,而LNF对改造后的HDV样病毒的复制水平无显著影响。通过上述研究发现人源HDV与动物源HDV在病毒的生命周期和药物的作用效果方面均存在较大差异。展开更多
The hepatitis delta virus(HDV)is a small RNA virus that encodes a single protein and which requires the hepatitis B virus(HBV)-encoded hepatitis B surface antigen(HBsAg)for its assembly and transmission.HBV/HDV co-inf...The hepatitis delta virus(HDV)is a small RNA virus that encodes a single protein and which requires the hepatitis B virus(HBV)-encoded hepatitis B surface antigen(HBsAg)for its assembly and transmission.HBV/HDV co-infections exist worldwide and show a higher prevalence among selected groups of HBV-infected populations,specifically intravenous drug users,practitioners of high-risk sexual behaviours,and patients with cirrhosis and hepatocellular carcinoma.The chronic form of HDV-related hepatitis is usually severe and rapidly progressive.Patterns of the viral infection itself,including the status of co-infection or super-infection,virus genotypes(both for HBV and HDV),and persistence of the virus’replication,influence the outcome of the accompanying and manifested liver disease.Unfortunately,disease severity is burdened by the lack of an effective cure for either virus type.For decades,the main treatment option has been interferon,administered as mono-therapy or in combination with nucleos(t)ide analogues.While its efficacy has been reported for different doses,durations and courses,only a minority of patients achieve a sustained response,which is the foundation of eventual improvement in related liver fibrosis.The need for an efficient therapeutic alternative remains.Research efforts towards this end have led to new treatment options that target specific steps in the HDV life cycle;the most promising among these are myrcludex B,which inhibits virus entry into hepatocytes,lonafarnib,which inhibits farnesylation of the viral-encoded LHDAg large hepatitis D antigen,and REP-2139,which interferes with HBsAg release and assembly.展开更多
Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagno...Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations.Until recently,interferon has been the only treatment for hepatitis D.Its efficacy is,however,limited and it is associated with significant side effects.A number of novel antiviral agents that target various stages of the HDV life cycle show promising results.They are currently in different phases of clinical development.This review focuses on the changing epidemiology,novel therapeutic agents,and updated management of chronic hepatitis delta.展开更多
文摘Current treatment options for hepatitis D are limited,with pegylated interferonalpha(PEG-IFNα)being the only therapy available in the Asia-Pacific region.However,PEG-IFNαhas limited efficacy and significant side effects.Pegylated interferon lambda acts on interferon-lambda(Type III)receptors predominantly expressed in hepatocytes.In 2023,bulevirtide was approved in the European Union and Russia for treating chronic hepatitis D.This drug works by binding to and inhibiting the sodium taurocholate co-transporting polypeptide receptor on liver cells,which is the primary entry point for the virus.Recently,several new drugs have entered various stages of development,offering hope for improved hepatitis D virus(HDV)management.Two more viral entry inhibitors are HH003 and tobevibart.Other agents include nucleic acid polymers(REP 2139-Mg),prenylation inhibitors(lonafarnib),and RNA interference-based therapies(elebsiran).Emerging trials are now considering combination therapies,such as SOLSTICE,a Phase 2 clinical trial evaluating tobevibart alone or combined with elebsiran.The combination dosed monthly achieved>50%virologic and biochemical response at 24 weeks of therapy.The efficacy and safety of these drugs will further be evaluated in ECLIPSE 1,2,and 3 trials.With these new treatments on the horizon,the prospects for improved HDV patient outcomes are promising.
文摘研究洛那法尼(Lonafarnib,LNF)对动物源丁型肝炎病毒(Hepatitis D virus,HDV)的影响,将完善对动物源HDV的认识,为进一步探讨其潜在致病性和传播特点奠定基础。利用点突变的方法对人源HDV复制模型进行改造来模拟动物源HDV的关键结构特征,利用转染、抗生素筛选的方法构建模拟的动物源HDV复制细胞模型,蛋白质免疫印迹法和间接免疫荧光法检测人源HDV复制模型改造后的HDV复制与蛋白表达情况,实时荧光定量PCR检测LNF对动物源HDV复制的影响。结果表明,改造后的HDV复制模型仍能在体外高效复制,可用于模拟动物源HDV的关键特征。与未处理组相比,LNF处理人源HDV复制模型后导致了HDV RNA的积累,而LNF对改造后的HDV样病毒的复制水平无显著影响。通过上述研究发现人源HDV与动物源HDV在病毒的生命周期和药物的作用效果方面均存在较大差异。
文摘The hepatitis delta virus(HDV)is a small RNA virus that encodes a single protein and which requires the hepatitis B virus(HBV)-encoded hepatitis B surface antigen(HBsAg)for its assembly and transmission.HBV/HDV co-infections exist worldwide and show a higher prevalence among selected groups of HBV-infected populations,specifically intravenous drug users,practitioners of high-risk sexual behaviours,and patients with cirrhosis and hepatocellular carcinoma.The chronic form of HDV-related hepatitis is usually severe and rapidly progressive.Patterns of the viral infection itself,including the status of co-infection or super-infection,virus genotypes(both for HBV and HDV),and persistence of the virus’replication,influence the outcome of the accompanying and manifested liver disease.Unfortunately,disease severity is burdened by the lack of an effective cure for either virus type.For decades,the main treatment option has been interferon,administered as mono-therapy or in combination with nucleos(t)ide analogues.While its efficacy has been reported for different doses,durations and courses,only a minority of patients achieve a sustained response,which is the foundation of eventual improvement in related liver fibrosis.The need for an efficient therapeutic alternative remains.Research efforts towards this end have led to new treatment options that target specific steps in the HDV life cycle;the most promising among these are myrcludex B,which inhibits virus entry into hepatocytes,lonafarnib,which inhibits farnesylation of the viral-encoded LHDAg large hepatitis D antigen,and REP-2139,which interferes with HBsAg release and assembly.
文摘Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations.Until recently,interferon has been the only treatment for hepatitis D.Its efficacy is,however,limited and it is associated with significant side effects.A number of novel antiviral agents that target various stages of the HDV life cycle show promising results.They are currently in different phases of clinical development.This review focuses on the changing epidemiology,novel therapeutic agents,and updated management of chronic hepatitis delta.
