Division of Gastroenterology, University of Torino, Molinette Hospital, Corso Bramante 88, Torino 10126, Italy.
Nat Rev Gastroenterol Hepatol. 2014 Jan;11(1):68-71. doi: 10.1038/nrgastro.2013.164. Epub 2013 Sep 10.
Immigration is fuelling a new reservoir of hepatitis D virus (HDV) in Europe, and hepatitis D still represents an important medical problem in the USA. The disease continues to be a major medical scourge in the developing world, in particular in countries such as Pakistan, Mongolia and Mauritania. New therapeutic strategies are being developed to disrupt interactions between HDV and its viral partner HBV, or with the host. Blocking or modifying the hepatitis B surface antigen (HBsAg) might interfere with the uptake or release of the hepatitis D virion; interference with host-mediated post-translational changes of proteins that are crucial to the HDV life cycle, such as prenylation, is another potential therapeutic option. At present, however, the only realistic option is to optimize IFN-α therapy. As eradication of HBsAg is the ultimate end point of therapy, long-term interferon administration might be required, raising an issue of tolerance in patients. Treatment with IFN-λ is a potential alternative approach to IFN-α; treatment of hepatitis C with this cytokine seems to cause fewer adverse effects than IFN-α and, therefore, might be more suitable for long-term treatment of HDV.
移民正在为欧洲的乙型肝炎病毒 (HDV) 提供新的储层，乙型肝炎病毒仍然是美国的一个重要医学问题。这种疾病在发展中国家仍然是一个主要的医学祸害，特别是在巴基斯坦、蒙古和毛里塔尼亚等国家。正在开发新的治疗策略来破坏 HDV 与其病毒伙伴 HBV 之间的相互作用，或与宿主之间的相互作用。阻断或修饰乙型肝炎表面抗原 (HBsAg) 可能会干扰乙型肝炎病毒粒子的摄取或释放; 干扰对 HDV 生命周期至关重要的蛋白质的宿主介导的翻译后修饰，如prenylation，是另一种潜在的治疗选择。然而，目前唯一可行的选择是优化干扰素-α治疗。由于消除 HBsAg 是治疗的最终目标，可能需要长期给予干扰素，这会引起患者的耐受问题。用 IFN-λ 治疗是替代 IFN-α 的一种潜在方法; 用这种细胞因子治疗丙型肝炎似乎比 IFN-α 引起的不良反应更少，因此可能更适合长期治疗 HDV。
